Please read carefully before submitting:

By checking this box, I certify that the statements made on this application for a volunteer position are true and correct, and I hereby grant Hospice Friends permission to verify the information contained herein. I understand the giving of false information or the failure to give complete information requested herein shall constitute grounds for rejection of my application or my dismissal from the program. I understand that my volunteer position is contingent upon the satisfactory completion of the required orientation and training, and the receipt of satisfactory recommendations from references. I hereby grant permission for Hospice Friends to investigate my references. Upon becoming inactive as a volunteer, I authorize the release of reference information on my work. I consent to a background check. My application includes my birthdate, other names (s) I have used, and the states I have lived in for the past seven years.