SHARE 0 0 0

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 take a few moments to complete this application. When you click “Send,” it will be sent to our Volunteer Coordinator, Carol Devine.

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.

Please note: Journey Home singers must be at least 18 years old. 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.

Date

Mr.Mrs.MissMs.

First Name

Middle Name

Last Name

Street Adress

City

State

Zip

Home Phone

Business/Cell Phone

Email address

Confirm email address

Can you be contacted at work?
YesNo

Occupation

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?

What have been your personal experiences with serious illness, loss (may include divorce, job loss, etc.) and death? How did you react in these situations?

Please Give a Brief Summary of Your Musical Experience:

REFERENCES

Please list two References (Name, address, phone, email).

1 | Name

Address

Phone

Email

2 | Name

Address

Phone

Email

I give permission for Cooley Dickinson Health Care to contact the references listed above (check box to agree)

If you would prefer to download and print your application, please click HERE, then email or mail it to our Volunteer Coordinator, Carol Devine, at the contact information below. Once reviewed, she will contact you about next steps.

SEND APPLICATION TO:

Carol Devine
Volunteer Coordinator
VNA & Hospice of Cooley Dickinson
168 Industrial Drive
Northampton, MA 01060
413-582-5354
CDevine4@cooleydickinson.org