Hospital Elder Life Program (HELP) Volunteer Application

Hospital Elder Life Program (HELP) Volunteer Application



Hospital Elder Life Program (HELP) Volunteer Application




Please provide two non-family references we may contact

Reference #1

Reference #2

Demographic Information: 

You may optionally provide the following information. It is used to help us get a better idea of the demographic make-up of our volunteer.


  • I understand that my application does not guarantee me a position as a Hospital Elder Life Program (HELP) volunteer
  • I understand that if selected to become a HELP volunteer, I will be required to complete the orientation process including, but not limited to, providing a Police Clearance, undergoing a Health Review, attending an orientation session, and completing the HELP volunteer training. 

If under 18 years of age, we require parental/guardian consent for application.

I understand that my child named in this application wishes to be considered for volunteer work and I hereby give my permission for them to serve in that capacity, if accepted by the Chatham-Kent Health Alliance. I understand that they will be provided with orientation and training necessary for the safe and responsible performance of their duties and that they will be expected to meet all the requirements of their position, including regular attendance and adherence to Alliance policies and procedures. I understand they will not receive monetary compensation for their services contributed.

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Chatham Campus

Chatham Site

80 Grand Avenue West
P.O. Box 2030
Chatham, ON N7M 5L9

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Wallaceburg Site

325 Margaret Ave
Wallaceburg, ON N8A 2A7