HILLVIEW HEALTH CARE CENTER
Best Time To Call:
Emergency Contact (name and phone number):
References: (non-relatives; list names, address, and phone;
- list your instructors);
II. This section for college students only.
Class requiring volunteer hours:
Hours required for classwork:
Frequency with which you wish to volunteer. (check preference)
Weekly (1,2, or 3 days)
Every Other Week
IV. Time Preference/Skills/Abilities. (check preference)
9:00 a.m. - 1:00 a.m.
1:00 p.m. - 4:00 p.m.
6:00 p.m. - 8:30 p.m.
ALL VOLUNTEERS MUST GO THROUGH A 1-HOUR ORIENTATION SESSION.
Days of the Week Preferred:
Any skills, hobbies, or previous experiences you would like to share:
Any physical limitations:
If yes, please explain:
I understand that it is my responsibility to keep confidential any information I learn about the
residents and/or their family, and that violating confidentiality is cause for immediate dismissal.
V. Possible Areas of Work Preference (Please mark your preferences.)
Help with Parties
Provide Instrumental Talent
Provide Vocal Talent
Help In Making and Putting Up Decorations
Taking Residents for Walks/Rides/Outings
Transporting Residents To Activities
Helping To Prepare for Special Events (Christmas, Halloween, Valentines, etc)
Book Cart (Distributing Books/Magazines/Puzzles)
Play Music/Read/Simple Games for Room Bound Residents
Help With Programs for Low Functioning Residents (Creative Stimulation, Lounger Program)
Work with the Resident Rooms
Teach a Special Talent
Assist During Craft Projects/Woodworking
Friendly Visits to Residents Rooms
Assist Exercise Group
Ladies Fingernail Painting
Help During Pop Corn Days
Bulletin Board Ideas