2024 Camp Memiki Volunteer Application

Camp Memiki Volunteer Application

To apply to become a Camp Memiki volunteer, please complete this form.
All camp volunteers will need to attend a one-hour training session provided by Hospice.
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
[email protected]
Phone Number*
Please enter a valid phone number.
Emergency Contact*

First NameLast Name
Relationship*
Are you currently employed?*

YesNo
Where are you employed?*
References
Reference 1*

First NameLast Name
Relationship*
Phone Number*
Please enter a valid phone number.
Reference 2*

First NameLast Name
Relationship*
Phone Number*
Please enter a valid phone number.
Previous experience with death/loss?
Personal Interests/hobbies*
I would like to be a buddy at Camp (All day commitment to the child you are with)?*

YesNo
I would like to be a Helper at Camp (Can be all day or for part of the day)?*

YesNo
I will go where needed.*

YesNo
T-Shirt Size*
I give Good Samaritan permission to release my picture and information concerning my volunteer work to the media as needed*

Agree
Should be Empty:

Camp Memiki Volunteer Application