The Lily House, Inc. · Volunteer Form

The Lily House welcomes community volunteers who bring a variety of skills and interests, along with an open and willing heart. Each volunteer role is important, and all roles complement one another. Every gift of time, talent, and expertise is appreciated.

After reviewing your volunteer application, we will be in contact with next steps which may include a brief in-person interview. All confirmed volunteers will receive comprehensive orientation and training.

Contact Information

Your Name *

First Name

Last Name

Address *

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Phone *

Email *

Verify Email *

Emergency Contact *

Emergency Contact Phone Number *

Info About You

Preferred Pronouns

Please choose all that apply to you: *

High School Student

College/University Student

Employed Full-Time

Employed Part-Time

Retired

Military Veteran

Active Military

Other

If you are a College/University Student, what is your course of study?

If you are employed full-time or part-time, please list your employer:

If you are a military veteran or active military, please list your branch of service:

If you checked "Other," please describe:

Are you a trained End-of-Life doula? *

Yes

If yes, where did you do your training ?

Are you a trained health care professional? *

Yes

If yes, please explain.

Are you multi-lingual? *

Yes

If yes, what languages do you speak?

Do you have prior experience serving as a volunteer? *

Yes

If yes, please explain.

Do you have any physical needs we should be aware of? *

Yes

If yes, please explain.

What are some of your hobbies and general areas of interest?

The Lily House

How did you hear about The Lily House? *

Why would you like to volunteer with The Lily House? *

Please list any special talents, abilities, and/or strengths you could bring to The Lily House.

Have you been a caregiver for someone who was chronically ill or dying? *

Yes

If yes, please explain, including how recently.

Have you had any experiences with death and dying? *

Yes

If yes, please explain, including how recently.

Please add me to The Lily House E-newsletter list. *

Yes

Volunteer Interests & Availability

For a detailed list of volunteer opportunities associated with the categories below, please click here.

Please select the area(s) you are interested in: *

Direct comfort care and companionship for residents

Support for resident’s friends and family

Household support

Clerical and administrative support

Programs and events

Artistic expression

Building and household maintenance and repair

Landscaping, gardening, and outdoor maintenance

I can commit to volunteer for: *

3 months

6 months

1 year

What days and times are you available to volunteer? Please select all that apply. A minimum of two hours within each time frame is preferred.

Monday

8am-12pm

12pm-4pm

4pm-8pm

8pm-11pm

Tuesday

8am-12pm

12pm-4pm

4pm-8pm

8pm-11pm

Wednesday

8am-12pm

12pm-4pm

4pm-8pm

8pm-11pm

Thursday

8am-12pm

12pm-4pm

4pm-8pm

8pm-11pm

Friday

8am-12pm

12pm-4pm

4pm-8pm

8pm-11pm

Saturday

8am-12pm

12pm-4pm

4pm-8pm

8pm-11pm

Sunday

8am-12pm

12pm-4pm

4pm-8pm

8pm-11pm

References and Background Checks

Please provide information for two (2) personal references.

First Reference *

First Name

Last Name

Relationship *

Email *

Verify Email *

Phone *

Second Reference *

First Name

Last Name

Relationship *

Email *

Verify Email *

Phone *

Have you ever have been found guilty, pled no contest, or had a conviction for any criminal act other than minor traffic violation? *

Yes

If yes, please explain.

I give The Lily House permission to conduct a CORI background check. This is required for volunteering. *

Yes

Non-Discrimination Policy

The Lily House does not discriminate against any person on the basis of race, creed, color, ability or disability, national or ethnic origin, sex, gender, age, sexual orientation, or self-identification.