MultiCare Health System

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MultiCare Volunteer Services

BRIDGES Supplemental Application

 

BRIDGES: A Center for Grieving Children
310 North K Street, Tacoma, WA 98403
Phone: 253-272-8266   Fax 253-305-0868


 

Name      Address   Age

City   State   Zip Code

Phone Number    Email Address   


 How did you hear about BRIDGES?


 

What are your goals or reason for wanting to volunteer at BRIDGES?

 

 

Have you experienced the death of a family member, colleague, or friend in the last year?

 

 

What kind of deaths have you experienced? When did they happen? How old were you?

 

 

I would like to talk with a supervisor about the possibility of using my time at BRIDGES for a community project or internship.

YES       NO

 

Do you have any medical issues we should know about?

 


Who should we contact in case of an emergency?

Name    Contact Number 

Relationship 

 

Please list two references (full contact information please)

First Reference:

Name      Occupation 

Street or P.O. Box 

City   State   Zip Code  

Phone Number   

Email



 

Second Reference:

Name      Occupation 

Street or P.O. Box 

City   State   Zip Code 

Phone Number   

Email

 

Thank you for completing this supplemental page for BRIDGES. After we review your full application, we will contact you for a brief phone or in-person interview.