Volunteer Application Form

Below is an online application form that will be submitted electronically to Mary Lou Prudham, our Hospice Service Volunteer Coordinator. 
If you would prefer to download and print an application form, please click here to find the form and submit to mlprudham@matthewshousehospice.ca

Name (First and Last) *
Name (First and Last)
Home Phone
Home Phone
Work Phone
Work Phone
Cell Phone
Cell Phone
Name, Phone numbers they can be reached at in case of emergency
Languages Spoken (other than English)
Are there Particular Times that You ARE Available to Volunteer? *
Select all that apply.
Are you Able to Be Called on Short Notice?
Would You Prefer a Regular or Casual Commitment?
Do you Have Use of a Car for Volunteer Work? *
What Area of Volunteering are you Interested In?
Around Matthews House
Check all that apply, or none
Have you ever been Convicted of a Criminal Offence for which a Pardon has not been Granted?
If you aren’t interested in being on a Board or Committee, please skip this question
Client Care
Check all that apply, or none
Bereavement
Check all that apply, or none
Are you comfortable volunteering in a smoking environment? *
Write “no” if you have no allergies or medical conditions.
I agree to complete a 30 hour volunteer program and understand there is a small fee to this program. *
I agree to provide 2 written references. *
I agree to provide a completed Police Check *
Today’s Date *
Today’s Date
I understand that by clicking “SUBMIT” and giving my virtual signature, all of the information is true and accurate to the best of my knowledge at this time.