Auxiliary Application Form

Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Date of Birth

Date

Phone Number

Please enter a valid phone number.

Email

example@example.com

Do you use text message?

Emergency Contact

Please enter a valid phone number.

Name

First NameLast Name

Days you are available

Skillsets or Area of Interests

Skills

Areas of Interest

Comments

Bibb Medical Center takes great pride in our skilled nursing , hospital and continuing care retirement community/ Our residents, patients, and tenants are our highest priority. It is important that each of our auxillary members has the same mentatlity and is committed to providing the best service(s) possible for the well-being of our residents, patients and tenants.

Along with saying that, BMC's auxillary organization is one of our most important organizations. You selflessly give in areas that our employees' sometimes cannot. Your job is important to not only staff but our residents, patients and tenants as well. We want for you to thrive in our auxillary organization and enjoy your commitment; therfore, we would like for you to give us some feedback on your interest/hobbies. We will do our very best to place you in an area in which you can build upon your own interests/hobbies while also helping others.