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Volunteer Application:

If you have any questions feel free to contact Ann Webb at awebb@trouvaillehomes.com or contacting the activities office at

612-608-1478.

Contact Information

Personal Information

Date*

Month

Day

Year

First name*

Last name*

Date of Birth

Month

Day

Year

Multi-line address

Country/Region*

Address*

City*

Zip / Postal code*

Phone*

Email*

Emergency Contact

Emergency Contact (First and Last Name)*

Emergency Contact Phone #*

Multi-line address

Country/Region*

Address*

City*

Zip / Postal code*

Relationship:

General Information

Personal Information

Are you applying as an:*

Individual (Adult)

Individual (Youth)

Organization

If individual (youth) what grade?

If organization what organization?

Have you ever been convicted of a felony or a crime? *

Yes

No

If yes, please provide details:

Do you consent to a background check?*

Yes

No

Current Employment/ School:

Volunteer Information:

How did you learn about Trouvaille?*

Why do you wish to volunteer at Trouvaille?

What prior volunteer experience do you have?*

Do you have any prior experience working with individuals who have Alzheimer's disease or related dementia? If yes, with whom, and where? *

Do you have any skills, interests, or hobbies that you would like to share with others? *

Do you prefer (select your preference)*

Individual Activities

Group Activities

Behind the scenes (office, kitchen, errands, etc.)

Availability:

How often do you like to volunteer?*

What days and times of day are you available to volunteer?*

Personal Reference:

References must be 21 years or older.

Reference #1

Name (First and Last)

Address

Relationship

Phone

Reference #2

Name (First and Last)

Address

Relationship

Phone

Signature*

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Date*

Month

Day

Year

Location

Trouvaille Memory Care Suites

6330 Hazeltine Blvd

Excelsior, MN 55331

(952) 474-4811

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