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Roberto Muniz
Michael Callan
Carol F Burt
Mary Lou Farmer
Anita Franzione
Donna V Lazartic
Gloria Zayanskosky
History
Our Mission
Our Vision
Executive Team
President’s Welcome
Parker Press
Parker at Landing Lane
Parker at River Road
Parker at Stonegate
Parker at The Pavilion
Nursing Care Residence
Assisted Living Residence
Adult Day Center
Parker at Monroe
The Andrew J. Markey Center for Health and Wellness
Research and Education
Child Development Center
Events Calendar
Working at Parker
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Employment Application
Home
Inside Parker
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Volunteer
Contact Us
VOLUNTEER OPPORTUNITIES
APPLICATION FOR VOLUNTEER WORK
First Name:
Last Name:
Address:
Address (Cont.):
City:
State:
Zip:
Date of Birth:
Date and time
Now
Home Phone:
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Cell Phone:
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Third part
Business Phone:
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Email:
In an emergency please contact:
Name/Relationship:
Emergency Phone:
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Second part
Third part
Building Preference:
Parker at Landing Lane:
Parker at River Road:
Parker at Stonegate:
Pavilion:
Previous volunteer experience:
Specific needs related to this volunteer experience:
Preferences:
Group Activities:
Individual Activities:
Administrative:
The Country Store:
Are you willing to assist residents at meal time?:
Yes
No
Please indicate your availability:
All Year:
Summer Only:
Internship:
Other:
Mornings:
Afternoons:
Evenings:
Monday:
Tuesday:
Wednesday:
Thursday:
Friday:
Saturday:
Sunday:
How were you refered to Parker Home:
Staff Member:
Volunteer:
Parker Home Website:
Family Member:
Internet:
Other:
Interests, talents and hobbies:
Art History:
Arts and Craft:
Bible Study:
Bingo:
Bird Watching:
Bridge/Pinochle/Blackjack/Poker:
Calligraphy:
Carpentry/Woodworking:
Checkers/Chess:
Church Services:
Clerical:
Collecting:
Computer:
Cooking:
Crocheting/Knitting:
Crossword Puzzles:
Exercise:
Dance:
Decorating:
Discussion Group:
Dramatics:
Flower Arranging:
Gardening:
Hair Styling:
Lawn Games:
Letter Writing:
Leather Crafting:
Music Appreciation:
Movies:
Needlepoint/Embroider:
Newsletter:
Pets:
Photography:
Poetry:
Political Group:
Public Speaking:
Reading:
Science:
Singing:
Sports:
Story Telling:
Travel:
Trips:
Walking:
Visiting:
Other:
Do you plan to play an instrument:
Yes
No
If yes what type?:
Would you be available for special events on occasional basis?:
Yes
No
Have you ever worked with people who have dementia?:
Yes
No
References:
First Name:
Last Name:
Phone Number:
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Second part
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Address:
Address (Cont.):
City:
State:
Zip:
First Name:
Last Name:
Phone Number:
(
)
-
Second part
Third part
Address:
Address (Cont.):
City:
State:
Zip:
Additional comments/needs:
Enter Security Code:
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