Journey Home Singers Volunteer Application

Thank you for your interest in becoming a singer for Journey Home Bedside Singers, a volunteer program associated with VNA & Hospice of Cooley Dickinson. Please note that recruitment and acceptance of new members is based on our needs at the time. Should our positions be filled, we will let you know and put you on our waiting list for future opportunities.

Journey Home singers must be at least 18 years old. Cooley Dickinson VNA & Hospice does not discriminate on the basis of race, color, national origin, religion, disability, sexual orientation, gender identity, or age in admission or access to treatment or participation in its programs or activities.

Please complete the form below to apply, or contact VNA Hospice Volunteer Coordinator Tina Leflar at cleflar@cooleydickinson.org to learn more!

Journey Home Singers Volunteer Application:

Date

First Name

Middle Name

Last Name

Address line 1

Address line 2

City

State

Zip code

Home Phone

Business/Cell Phone

Email Address

Confirm Email Address

Can you be contacted at work?

YesNo

Please tell us something about yourself.

Why do you want to be a Hospice volunteer singer? What do you feel you would bring to the program?

Have you had personal experience with serious illness, loss (may include divorce, job loss, etc.) or death?

YesNo

Please give a brief summary of your musical experience:

What is the range of your voice?

REFERENCES

Please provide the name, address, phone number and email of two individuals whom we might contact for letters of recommendation. You can also email this information separately now or after an initial interview to VNA Hospice Volunteer Coordinator Tina Leflar at cleflar@cooleydickinson.org.

Refernce 1

First & Last Name

Address

Phone

Email Address

Refernce 2

First & Last Name

Address

Phone

Email Address

I give permission for Cooley Dickinson Health Care to contact the references listed above.

I Accept

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Journey Home Singers Volunteer Application

Journey Home Singers Volunteer Application:

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