Volunteer Services Application

Hospice of Fayette County welcomes volunteer participation and depends upon volunteers to help accomplish the work done by this agency. If you are interested in becoming a volunteer for Hospice, please complete the following form and mail to Coordinator of Volunteer Services at the address below.

Name: *

Street Address:

City: OH

Zip Code:

Home Phone: *

Work Phone:

Cell Phone:

Which of these activities would you be more interested in as a Hospice Volunteer? Please check all that apply:

friendly visitor in nursing facility

friendly visitor in patient's home

patient care/caregiver relief

running errands/shopping for patient/family

meal preparation

light housekeeping

clerical/office duties

fund-raising event

public relations

public speaking

grassroots/advocacy support

board member

How did you hear about the Hospice Volunteer program?:

E-Mail: