Online Volunteer Application

* = Required Field


*first name  

middle initial

*last name  

*address  

(address line 2)

*city  

*state  

*zip/postal  -       

*e-mail:    

*home telephone  

emergency telephone  

business telephone  

cell phone  

Is anyone else at this address already a volunteer here?

If yes, what is their name?

Have you ever served as a volunteer with us before?


education level (check all that apply)  

 

Are you retired?

current employer

recent former employer

List any skills that can be used in health care

List any business or hospital equipment you can operate

Day(s) and time(s) you would like to volunteer

Areas of the retirement village in which you would like to volunteer







 

How did you hear about the Village North Retirement Community volunteer program?  

 

Have you ever been convicted of a felony?  

 
Please Note:  

All applications are reviewed and interviews scheduled when appropriate.
Appointments are determined by volunteer interests and the needs of Village
North Retirement Community. Upon assignment, you will receive applicable
training.

Commitment:  

I agree to give regular and dependable volunteer service to Village North
Retirement Community. I certify that the above information is true and
accurate to the best of my knowledge.

*applicant's name  
Date