Volunteer Application Form Name: Address: City: Phone: E-mail: First Language:
□ 340 College Street □ Post-op support □ Information
Apt. #: Postal Code: Date of Birth:
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Other Language(s):
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Potential Areas of Interest Kensington Gardens □ Kensington Hospice Pastoral/Religious □ Reception Services □ Nutrition Dining Assistance □ Complimentary Friendly Visitor Therapy Reception □ Music Care Café □ Resident & Life Enhancement Family Care and Special Events
□ Second Mile Club □ Friendly Visitor □ Medical and/or □ Translation □ Escort □ □ Program, □ Lunch, Special □ Events □ Transportation Assistant If you would like to volunteer in other ways, please specify: _____________________________
Why would you like to volunteer with Kensington Health?
Please list and describe your previous volunteer experience. (If any)
What are your special interests/hobbies?