Camp Erin - Albany 2019 Volunteer Application
Thank you for your interest in volunteering for Camp Erin – Albany, 2019:
Friday-Sunday, September 20 - 22, 2019, with the Ice Cream Social on Saturday, September 7th, 2019

VOLUNTEER POSITIONS:
Cabin Buddies (60) - Recommended for new volunteers. 5 Cabin Buddies in a cabin with 5 campers.
Big Buddies (12) - Returning volunteers only. One per cabin. Provides their own transportation to Camp Fowler.
Grief Counselor (12) - Typically Hospice staff. One per cabin. Provides their own transportation to Camp Fowler.
Photographer (2) - One male and one female. Experienced photographers and former volunteers preferred.
Med Team (2) - RNs administer medications for all campers. Available 24/7 for all medical needs.

REQUIREMENTS FOR ALL VOLUNTEERS:
1. Must be at least 18 years of age
2. Must have graduated from High School
3. Must attend Ice Cream Social and entire Camp Erin weekend
4. Interview and training required for new volunteers.
5. Annual background check, for new and returning volunteers, paid for by The Community Hospice.

Email address *
ID Badge:
What name or nickname would you like printed on your nametag?
Your answer
First Name: *
Your legal first name please - required for our online background check - paid for by The Community Hospice.
Your answer
Last Name: *
Your legal last name please - required for our online background check - paid for by The Community Hospice.
Your answer
Gender:
With which gender do you identify?
Date of Birth: *
MM
/
DD
/
YYYY
Mailing Address:
Your answer
City:
Your answer
State:
Your answer
Zip Code:
Your answer
Phone:
Best phone number to reach you. Feel free to list more than one! xxx-xxx-xxxx format please!
Your answer
Occupation and Employer:
If you are currently a student, please enter "student" and specify which college or university you attend.
Your answer
Ethnicity:
For statistics
T-Shirt: *
What size Camp Erin T-shirt would you like at the end of camp?
Position: *
What position(s) are you applying for?
Required
Returning?
Are you a returning volunteer? Please check the year(s) you attended Camp Erin - Albany weekend.
Age Range Preferences?
What age range of campers are you most comfortable with?
Cabin Buddies?
Is there anyone you would like to share a cabin with? Please list names here:
Your answer
Campers?
Do you know any campers attending this year's camp? Please list their name and their relationship to you.
Your answer
Certifications:
Please list any relevant certifications, education, licensing, or training. Ex: CPR, First Aid, RN, LMSW, Grief & Loss, etc.
Your answer
Emergency Contact: *
Who would you like us to contact in the event of an emergency? Please include name, relationship, and phone number(s).
Your answer
Cabin Preferences?
Which cabin(s) would you prefer?
Allergies / Dietary Needs
Please list if you have any allergies (food, environmental, medicinal, etc), dietary needs or restrictions. If none, leave blank.
Your answer
Health Restrictions/Concerns
Please list if you have any physical or mental health conditions, concerns, limitations or diagnoses. If none, leave blank.
Your answer
Recent Loss?
We recommend all individuals with recent losses to wait at least a year before volunteering for Camp Erin. Have you loss someone close to you within the last year? If yes, please specify the date and relationship to you.
Convictions *
Have you ever been convicted of, or pled guilty to, a felony or misdemeanor?
Confidentiality Statement *
Volunteers will have access to confidential information, including protected health information (PHI), both written and oral, in the course of their volunteer responsibilities. It is imperative that this information is not disclosed to any unauthorized individuals. I understand that if I do not keep protected health information (PHI) confidential, or if I allow or participate in inappropriate disclosure or access to PHI, I will be subject to immediate disciplinary or corrective action, up to and including dismissal. I understand that unauthorized access, use, or disclosure of PHI may also violate federal and state law, and may result in criminal and civil penalties.
FOR NEW VOLUNTEERS ONLY
Referred By:
Please share with us how you heard about Camp Erin!
Your answer
Additional Information:
Please share with us some more information about yourself. Include any unique skills, talents, interests, relevant work or volunteer experience.
Your answer
A copy of your responses will be emailed to the address you provided.
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