Welcome to Spectrum Health Volunteer Services
Spectrum Health Hospice Volunteer Application
Please create a user name and password in order to submit application.
User ID/e-mail address
User ID/e-mail address confirm
Spectrum Health Volunteer Application
Hospice and Palliative Care
Date of Birth
Address Line 1
Permanent Address (only if different than current)
Address Line 1
Address Line 2
Preferred Email Address
May We Text You? (Check if Yes)
Preferred Phone Number
Emergency Contact Information
Relationship to You
Have you ever been convicted of a crime?
If yes, please explain:
Are you eligible to work in US?
Are you a US Citizen?
If no, documentation may be required at a later time.
Highest Level of Education Completed
Degree Field/Area of Study
Are you a current student?
Are you required to volunteer (i.e. high school or college requirement)?
Are you receiving credit for volunteering (i.e. college course)? Check box if yes.
Are you currently employed?
Current/Most Recent Employer
Have you ever been employed by Spectrum Health?
If yes, please list the dates, role, entity, and department you worked in.
Have you ever volunteered at Spectrum Health?
If yes, please list the dates, role, entity, and department you volunteered in.
If you have worked or volunteered at Spectrum Health under a different name (i.e. maiden name), please list it below:
Is there any employment and/or volunteer experience you would like to share with us?
Please explain your interest in volunteering at Spectrum Health:
Additional Languages Spoken
How did you hear about us?
Where are you interested in volunteering?
How long are you willing to commit to volunteer?
Availability (check all that apply)
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.
Electronic Signature (type your full legal name in the box below)
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.