Application for Hospice Volunteer Services
Altru's Hospice
1380 South Columbia Road
Grand Forks, ND 58201
* Denotes required fields

Prior Experience

Personal Experience with Death

* Have you experienced the death of a family member or friend within the last year?


* Do you drive?
* Do you have a car at your disposal?
* Do you have car insurance?


Reference 1

Reference 2

Referral Source

I certify that the statements made in this application are true and correct. I understand my electronic signature indicates approval to check references. As a Hospice volunteer, I agree to abide by all hospital rules and regulations.

Note: Federal and State laws prohibit discrimination because of race, color, religion, sex, national origin, age or handicap.