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Sign up to Become a Volunteer or Employee
Are you interested in volunteering or employment ?
*
Volunteer
Employment
First Name
Last Name
Email Address
*
Phone Number
*
Street Address
*
Apartment, suite, etc
City
State/Province
ZIP / Postal Code
Date available to start
*
Have you ever been convicted of a felony?
Yes
No
Are you 18 years old or older?
*
Yes
No
How did you hear about Advocate Assisted Living?
Friends & Family
Google ad
Instagram
Facebook
Other
What interests you in volunteering with seniors with dementia?
Languages spoken
Preferred time to volunteer (please check all that apply)
Days (9am-5pm)
Evenings (after 5pm)
Weekdays (Monday-Friday)
Weekends (Saturday-Sunday)
Type of volunteer work you're interested in (please check all that apply)
Phone/video calls with residents
Individual residents visits
Assist with activity programs
Provide entertainment or music
Organize/cleanup
Games/bingo
Decorate for the holidays
References
Reference #1
First Name
Last Name
Phone Number
Relationship
Years known
Street Address
Apartment, suite, etc
City
State/Province
ZIP / Postal Code
Reference #2
First Name
Last Name
Phone Number
Relationship
Years known
Street Address
Apartment, suite, etc
City
State/Province
ZIP / Postal Code
Reference #3
First Name
Last Name
Phone Number
Years known
Relationship
Street Address
Apartment, suite, etc
City
State/Province
ZIP / Postal Code
Emergency Contact
First Name
Last Name
Phone Number
Relationship
Disclaimer
I certify that my answers are true and completed and answered to the best of my knowledge. This also allows Advocate Assisted Living INC to use my information to complete a background screening and any other screening required by Advocate Assisted Living INC to evaluate my Volunteer & Employment status.
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