Compassionate Neighbour Application Form

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Garden House Hospice Care complies fully with current Data Protection Act 2018 and Freedom of Information legislation.  All the information on this form is confidential and will not be shared without your permission. Read our privacy policy here.
Personal Information

(Not Required)

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Click << to change the year and < to change the month.

Emergency Contact Information

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Reference Information

Please provide the names and addresses of two referees that have known you at least six months or more. These can be teachers, employers or friends, neighbours etc. (including places that you currently volunteer)

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(e.g. Friend/Manager/ Teacher)

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(e.g. Friend/Manager/Teacher)

Garden House Hospice Care Statement of Confidentiality

Volunteer Declaration

Media Consent