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Spectrum Health Hospice Volunteer Application
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Spectrum Health Volunteer Application
Hospice and Palliative Care

Personal Information

Current Address
Permanent Address (only if different than current)
Contact Information
Emergency Contact Information
History
If no, documentation may be required at a later time.
Education/Employment
Volunteer Interest
References
Reference #1 (No family members please)
Reference #2 (No family members please)
Agreement and Electronic Signature
Please Read the Following Statement Carefully Before Signing to Indicate Your Understanding:
I certify that I am able to perform the essential duties of the volunteer position. In the event that I have a disability that will affect my ability to take an assignment, I will inform Spectrum Health Hospice prior so that reasonable accommodations can be made. Spectrum Health Hospice reserves the right to require medical documentation regarding the need for accommodation.

I certify that the facts in this application are true and complete to the best of my knowledge and understand that falsified statements on this application may result in termination as a volunteer.

I understand and agree that my volunteering is for no definite period and may be terminated with or without case, at any time, with or without notice.

I authorize investigation of all statements contained in this application. I release the listed references to provide you with any and all applicable information they may have. I hereby release these references from all liability for any information they may give to Spectrum Health Hospice.
Thank You for taking the time to fill out an application to volunteer at Spectrum Health!

Please click "Submit my Application" below. You will receive a confirmation message on your screen, as well as to your email.