Why do you want to volunteer?  How did you hear about the Residence at Morgan Heights?

Which volunteer position interests you? (you can check more than one)

Have you worked with seniors before?  yes   no

Do you feel comfortable working with confused residents?  yes   no

Do you feel comfortable working with frail or very sick residents?   yes   no

Are you familiar with wheelchairs and how to move people in them?  yes   no

What language(s) do you speak?
 

What other volunteer experience do you have?
 

What talents do you have that you would be willing to use here? (Playing an instrument, craft, etc.)
 

When are you available to volunteer?
 

Requirements for Volunteering (You Must Have the Following):
• Criminal Record Check or Student Referral Form
• Tuberculosis Skin Test
• Influenza Immunization

References: (i.e., teacher, employer, volunteer supervisor)

Reference 1
Name:    Phone:  

Reference 2
Name:    Phone:  

We at The Residence Morgan Heights believe in the right to keep anything that we know about residents confidential. Information that you learn about a resident is to aide in your services as volunteers and is only to be shared within the bounds of The Residence of Morgan Heights. Failing to comply with this standard will result in immediate termination of your volunteer position. When discussing volunteer work, please remember not to divulge the names or characteristics of residents.

If approved as a volunteer, I agree to abide with the policies and procedures of this facility. I shall indemnify and hold harmless The Residence of Morgan Heights against any and all (i) liability, loss, claims, damages or expenses, including legal expense, due to or arising out of injury to any person, (ii) damage to, loss or theft of any property of any person arising out of any act or neglect by any party or those over whom it might expect to exercise control. I am also aware that I can contact the volunteer supervisor at The Residence of Morgan Heights to discuss any concerns I may have - 604.535.1118.

I have read and understand the above statement.