Membership/Volunteer Form

Membership/Volunteer Application/Renewal Form

Contact Information

First Name:

Last Name:

Group/Business Name (if applicable):

Email:

Phone:

Address:

City:

Province:

Postal Code:

Membership Information

New MembershipMembership Renewal

Volunteer Interests

Assisting at EventsEnd-of-life CompanionBereavement CompanionHospice BoardHospital KioskOtherNone

Administration Office (For admin use only)

Date of receipt:

Entered into Membership/Volunteer Master Spreadsheet

For New Volunteers:
Confidentiality Agreement Signed
Photo Consent Signed
Proof of Covid and Influenza Vaccination Provided (if applicable)
Proof of completion of End-of-Life or Bereavement Companion Training (if applicable)
MAiD Policy Signed (if applicable)
Criminal Record Check Completed (if applicable)