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Reference code:

Volunteer Application


Contact Information

Emergency Contact

Availability

During which hours are you available for volunteer assignments? (Evening and Sat/Sun shifts are only for gift shop)
Shifts
Days *

Interests

Tell us in which areas you are interested in volunteering
Which location are you interested in?

References

List 3 Persons (Other than Relatives)

Volunteer Information

Special Skills or Qualification

Previous Volunteer Experience

History

Have you ever been convicted of a Felony?

Current Employment/School

May we contact

Disclaimer and Signature

By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal.

I understand that Memorial Hospital reserves the right to not accept all applicants or to terminate a volunteer if performance standard is not in compliance with The Joint Commission and State of California Standards for volunteer service. A performance evaluation will be completed on all volunteers assigned to Mercy Hospitals of Bakersfield. It is further understood that before I begin a volunteer assignment, I must first complete the Hospital Required Medical Tests and Orientation Training.

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