• Volunteer / Internship Application Form

    Thank you for your interest in volunteering with PUSH Birth Partners®. Volunteers are a vital part of our mission and help us in many ways. We appreciate everyone who gives us the gift of their time, knowledge, and skills and we welcome an array of volunteers who are interested in contributing their time and talents. Completion and submission of this application, which consists of three sections, is required to be considered for a volunteer or internship opportunity.  

  • Qualifications and Volunteer Clearance: 

    Volunteers must be at least 18 years old and complete the clearance process, which includes a background screening check. Volunteer clearance must be renewed every two years. This applies to any students completing their internship/practicum with the organization.

  • Section 1: Basic Information

  • Section 2: Volunteer / Internship Information

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  • Section 3: Resume

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  • References

    Applicants who are invited to join PUSH as a volunteer/intern will be required to submit at least two references as part of the screening and onboarding process. If you choose to upload your reference list at this time, please provide complete information (full name, mailing address, e-mail address, and relationship to the applicant) on non-family references that have known you for a minimum of two years.
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  • Background Check Disclosure

    PUSH may obtain arrest and conviction records on all potential volunteers. An arrest or conviction will not automatically eliminate you from consideration for volunteering. However, failure to disclose all pending charges and/or convictions may lead to your disqualification or termination of volunteering with PUSH. Examples include, but are not limited to driving while impaired, worthless checks, assault, driving while license is suspended, disorderly conduct, credit card fraud, embezzlement, etc.

  • Agreement and Acknowledgement

    As a volunteer/intern I agree: I will consider as confidential all information which I may hear or see, directly or indirectly, concerning a client, client family member, doctor, or other health care professional and I will not seek information from any of the above regarding a client. I hereby certify that the answers on this application and any resulting from interviews are true and correct and that any misrepresentation or omissions of facts, misleading, or false information on my part will be grounds for dismissal as a volunteer/intern. Acceptance as a volunteer/intern is contingent upon satisfactory references, verification of information submitted on the applications, and satisfactory completion of mandatory requirements. I authorize that all employers or references thus contacted be released from all liability in answering questions related to my application. I understand that I may be required to commit to serve a regular schedule of at least 144 hours in a calendar year or agree to be an on-call volunteer. My services are donated to PUSH without contemplation of compensation or future employment and given with humanitarian or charitable reasons.
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