Volunteer Form

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This form may be filled out online or printed and mailed in
Phone 206-624-5704
Hilltop House
1005 Terrace Street, Seattle, Washington 98104

Volunteer Application





I. Skills and Interests

II. Preferences in Volunteering

III. Availability

IV. Background Verification

1. Have you been convicted of a criminal offense?

2. Have you ever been charged with neglect, abuse, or assault?

3. Has your driver's license ever been suspended or revoked in any state?

4. Do you use illegal drugs?

5. Do you have any physical limitations or are you under any course of treatment which might limit your ability to perform certain types of work?

6. Please list two non-family references whom we might contact:



7. How did you hear about us?

Hilltop House Retirement Community
1005 Terrace Street
Seattle, Washington 98104
206-624-5704