Text Size:
Smith Senior Living - Chicago, IL
Senior living community
retirement home
Volunteer Application Form

Items marked with a * are required.


spam Name:
spam Subject:
*Name:
 First
 MI
 Last
  If you are part of an organization please enter it here:
*Address:
*City:
State:   *Zip Code:   
*Daytime Phone: Home    Office
Cell Phone:
*Email:
 
I am a student, 18 or under, attending School and I am seeking to fulfill service hour requirements.
 
I Learned about this volunteer opportunity from:
Resident Staff member
Neighbor Publicity
A group in which I'm involved
 
Have you ever applied for employment at a Smith Senior Living Community?
Yes No
Have you ever been employed by a Smith Senior Living Community?
Yes No
 
I would like to volunteer at:
Smith Crossing Smith Village
 
PLEASE FILL OUT THE INFORMATION BELOW
I am interested in volunteering because:
 
The choices listed here are volunteer opportunities available at both Smith campuses. Your preferences will be discussed with you fully at your required orientation.
Opportunities:
 
Special Skills, Hobbies, Interests
Other volunteer experience
I prefer to volunteer with the community of residents in:
Independent Living 
Assisted Living 
Alz / Memory Support 
Skilled Nursing 
Schedule Preferences
Frequency Once only   Once a week   Once a month   As needed
Day of Week Sun  Mon  Tue  Wed  Thur  Fri  Sat 
Time of Day Morning   Afternoon   Evening  

*In order to be a volunteer, I understand that attending orientation is mandatory and, based on my volunteer assignment, some additional training may be provided. I am also aware that before I begin volunteering I will be required to comply with Smith Senior Living’s policy to take a TB screening test, a security background check and a drug screening test. I understand that Smith Senior Living will pay for the costs of these tests.