Application form

Candy Striper Volunteer Program

Volunteer

We are looking for a few good volunteers that can donate 4 hours of their time a week. If you are interested in assisting in activities with our patients, transporting, and simply want to be in the hospital environment the Candy Striper program may be for you. The schedule is flexible. Male or female welcomed. Please contact the Director of Nurses, Fran St. Pierre.

Personal Information

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Referral Information

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Placement Information

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Education

High School

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College

Graduate School

Vocational School/ Other

Certifications / Licenses

License 1

License 2

License 3

License 4

Skills & Qualifications

Employment History

Current Employer

Previous Employer 1

Previous Employer 2

References

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Reference 1

Reference 2

Reference 3

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