Volunteer Application

3737 Bryant Avenue South · Minneapolis, Minnesota 55409
Phone: (612) 827-5931 · (800) 735-3048
cskaret@walkermeth.org
Personal Information
    
  

      

      

Which way do you prefer to be contacted? Home Phone Cell Phone Work Phone Email
 Volunteer Type
Are you volunteering to fulfill a community service requirement?
No      Yes, I need to complete hours within months
Emergency Contact
      
Experience
    

  
Availability
Please check all that apply:

Monday: Morning Afternoon Evening
Tuesday: Morning Afternoon Evening
Wednesday: Morning Afternoon Evening
Thursday: Morning Afternoon Evening
Friday: Morning Afternoon Evening
Saturday: Morning Afternoon Evening
Sunday: Morning Afternoon Evening

 Are you willing to make a six month commitment to Walker Methodist Health Center? Yes No
Volunteer Opportunities That Interest You
Gift Shop Greenhouse Ice Cream Stand Worship Service
Activities Assistant Arts/Crafts Games Music Therapy
Field Trips/Outings Resident Visitor Pet Visits Mail Delivery/Sorting
Specialty Parties Other

Which do you prefer to be? Group Leader   Group Assistant  Either
Miscellaneous Information
Do you know any volunteers at Walker Methodist Health Center?
Yes If yes, who? No

Have you served as a volunteer before?
Yes If yes, when? No

Are you familiar with Alzheimer's and dementia?
Yes No

 How did you learn about Walker Methodist Health Center?
Reference
      
Additional Comments
Read before Signing:

I understand that any offer of volunteer service is conditional upon completing and passing a Mantoux (tuberculosis) screening, acceptable reference check, criminal background check, and completion or orientation.

I authorize investigation of all statements in this application, and I understand that misinformation given on my volunteer application form and during the interview process is sufficient cause for discharge.

I understand that this information is to be kept confidential and will be used only in finding the most suitable placement for me.

I understand that I will NOT be paid for my services as a volunteer.

I have read and understand the conditions listed above.