Page Menu Mobile Menu Button

Children's Bereavement Volunteer Application

Please click the button below and download the additional required documentation. Save the document to your computer, and complete the required fields. Once complete, attach to the end of this application.

Required Documents to Sign

Name:  *Date of birth:  *Mailing address:  *City:  *State:  *Zip code:  *Phone:  *Secondary phone: Email address:  *Previous employment:  *Job title:  *Experience working with children/teens:  *Who should we contact in an emergency? Name:  *Relation:  *Phone:  *What reservations might you have about working with grieving children or adults?  *Any other information you feel important that you would like us to know?  *

Due to the nature of the Children’s Bereavement Program, we reserve the right to accept or reject potential volunteers. I acknowledge that a background check will be done prior to my acceptance into this program. The above statements are true to the best of my knowledge. I know no reason that I would not make a qualified Children’s Bereavement Program volunteer.

Please List Two Personal References: (Name, Address, Telephone)  *Attach required documentation:  *