Volunteer Application

Noi Hana Manawaleʻa

Thank You for Your Interest in Volunteering with Kaua‘i Hospice! We’re excited to learn more about you and how you’d like to contribute to Kaua‘i Hospice and the families we support. Our goal is to understand how we can best assist you in your volunteer journey. Rest assured, all information provided will be kept strictly confidential. Once we receive your completed application, a Kaua‘i Hospice representative will reach out to discuss the next steps in becoming a volunteer. Thank you for helping us get to know you better!

Volunteer Application

Phone Number:
Person to notify in case of emergency:
Phone Number:
Are you currently employed?
May we call you at work?
Are you a Veteran?
Have you had experience serving as a volunteer?
Are you currently serving as a volunteer with any other organization, club, etc?
Are you willing to provide transportation for patients/ families if needed?
Do you have a valid Hawaii Driver’s License?
Do you have current Auto Insurance with minimum automobile liability coverage in compliance with Hawaii State Law?
Have you had a life experience, education or special training in which you feel would be helpful to you in your work?
Has someone close to you died?
In the last year, have you experienced a major life change (work situation, relationship, made a major move)?
Check all areas that you would be interested in helping with:
Check any special skills/interests you might be willing to contribute to Hospice:
Foreign languages
List three references (one professional, two personal), other than immediate family, who know you well:
Date:
This field is for validation purposes and should be left unchanged.

ʻAʻohe hana nui ke alu ʻia.

No task is too big when done together by all. If everyone contributes to the task, it lightens the load.