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COVID-19 UPDATE: How Transitions LifeCare is working to protect our patients, families, and team members. Read More.
Volunteer Application
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Volunteer Application
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Use the form below to apply to be a volunteer.
Volunteer Application
Transitions LifeCare does not discriminate in their selection of volunteers, hiring or employment on the basis of race, color, sex, disability, national origin, citizenship, or on the basis of age with respect to persons 18 years or older. No question on this application is intended to secure information to be used for such discrimination. Transitions LifeCare will hold you responsible for the accuracy of the statements you make on this application. Incomplete applications will not be considered.
Name
*
First
Last
Address
*
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Phone (Home)
*
Phone (Cell)
Phone (Work)
May we call you at work?
Yes
No
Email
*
How do you prefer to be contacted?
*
Phone
Email
Are you 18 years or older?
*
Yes
No
How did you learn about volunteer opportunities at Transitions LifeCare?
*
What volunteer opportunities are you interested in?
Check all that apply
Select All
Patient & Family Support
Administrative/Office
Specialty - We Honor Veterans
Specialty - Musical Presence
Specialty - Massage
Specialty - Pet Partner
Specialty - Vigil Support
Other
What days & times are you available to volunteer?
*
Have you been impacted by a personal loss in the past 12 months?
*
Yes
No
Special skills
Check all that apply
Select All
computer
arts/crafts
writing
fundraising
other
Please list languages you speak fluently
Volunteer / Employment history
List most recent first
Agency/Employer
(include position and years of employment)
Agency/Employer
(include position and years of employment)
Agency/Employer
(include position and years of employment)
Are you presently enrolled at a school or university?
If yes, list school and graduation year.
What is your current area of study?
Community Recommendations
Reference forms will be sent to the names provided. Please provide either a mailing address including zip code or an email address for each reference
Name, Mailing or Email address
*
Name, Mailing or Email address
*
Name, Mailing or Email address
*
I have registered for a Volunteer Information Session.
*
Yes
No
I certify that the answers given herein are true and complete to the best of my knowledge
*
(type name and date in box)
Phone
I would like to receive information from Transitions LifeCare (includes newsletters, organizational updates and announcements, or solicitations).
Yes
No
Name
This field is for validation purposes and should be left unchanged.
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