New User Details
User ID (verify)
Please create your desired User ID and Password above.
(User ID must be a valid email)
For help contact:
Essentia Health East Volunteer Services 407 East Third Street Duluth, MN 55805 (218)786-4420
Hospice Volunteer Application
Volunteer Services Mission Statement
Volunteer Services is dedicated to provide the highest
quality of volunteer support to those we serve within the region
**Please advise us if any accommodation is needed to participate in the application process.**
High School Student (Parental Consent Needed)
Relationship to Volunteer
Education and Work Experience
Post Secondary School (if applicable)
Did you graduate?
Have you ever been employed by Essentia Health?
Your Name at the time
Can you commit to volunteering at a regular scheduled time?
How did you hear about volunteering?
Why do you want to volunteer?
References - Do Not List Relatives
Day Time Phone
Day Time Phone
I hereby authorize investigation of all statements contained in this application. I further authorize my reference permission to furnish Essentia Health East with facts and opinions as to my job performance, capabilities and desirability as a volunteer. I further release all persons whomsoever from any damage because of furnishing said information.
The information in this application is accurate and correct to the best of my knowledge.
I agree as a volunteer my time and talents will be given freely without any expectation of monetary reimbursement.
I am participating in a community program, which reimburses me for volunteer service hours.
My typed name shall have the same force and effect as my written signature.
Volunteer opportunities are provided without regard to religion, creed, race, national origin, sexual orientation, age, gender, disability, marital status or status with regard to public assistance. Essentia Health East does not imply that you will be assigned a volunteer position and this application should not be construed as a contract or promise of a volunteer position.
Hospice Volunteer Form 2016