Christian Care - Assisted Living Facility

Yes! I'm interested in volunteering...

Please fill-out some basic information to help us better review your volunteering interest at our ASSISTED LIVING facility.
Thank you!

First Name(*)

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Last Name(*)

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E-mail(*)

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Date of Birth

Street Address

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2nd Address Line

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City

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State

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Zip Code

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Phone: Cell

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Phone: Home

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Referred By

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Agency/Organization or Business Affiliation

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List current/past family member residents

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Days/Times you are available

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List any relevant skills you have that may help us utilize your abilities

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Emergency Contact: Name, Relationship, Home & Cell Phone

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Because we work with vulnerable adults, we are required to do a criminal background check on potential volunteers. We will contact you to arrange a convenient time in the near future to initiate our volunteer intake process. Thank you for your interest in Christian Care and in reaching out to help us to provide faith, hope and love to our residents.