IMCA Compassion Circle Training Application

The IMCA Compassion Circle is a specialized volunteer initiative to train a cohort of 25 individuals to provide spiritually grounded, culturally competent care for Muslim patients in hospitals and nursing homes.

First Name

Last Name

Phone/Mobile

Gender

Male

Female

Preferred Method of Contact

Call

Text

Address

City

State

Zip Code

Availability

Are you able to attend the full training program?

Yes

General Availability (check all that apply) to respond to volunteer opportunities:

Weekday Mornings

Weekday Evenings

Weekends Mornings

Weekends Evenings

Are you open to hospital/nursing home visits after training?

Yes

Background & Experience

Do you have any of the following experience? (check all that apply):

Healthcare (clinical or non-clinical)

Counseling / Social Work

Chaplaincy / Religious leadership

Community volunteering

None

Briefly describe any relevant experience (2–3 sentences):

Motivation & Readiness

Why are you interested in joining the Compassion Circle?

Are you comfortable supporting individuals facing serious illness, aging, or end-of-life situations?

Yes

Somewhat

Faith & Sensitivity Alignment

Are you committed to providing care rooted in Islamic values with compassion, confidentiality, and professionalism?

Yes

Languages spoken:

Screening & Compliance

Are you willing to complete a background check if required by partner institutions?

Yes

Do you have reliable transportation?

Yes

Final Acknowledgment

I understand that: This is a training-based selection process with limited seats (25 participants).
Participation requires commitment to active volunteer placement in IMCA to visit hospitals, residents, and nursing homes.

Professional conduct, confidentiality, and consistency are expected.

IMCA Compassion Circle Training Application