IH_Adult Volunteer form

Infirmary Health System Volunteer Application

Our Mission if LIFE
Please check the facility at which you are interested in volunteering:
Name

First NameLast Name
Preferred Name
Age
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Secondary Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Social Security Number
Drivers License #
Please enter your state then number. Ex: AL 1234567
Birth Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Gender
Primary Email
example@example.com
Are you employed? If so, please list employer.
How did you learn about our program?
Have you done volunteer work before? If so, please list where.
What are your hobbies, interests, and special skills?
Do you know anyone who currently volunteers with Infirmary Health? If so, please list who.
Why are you considering volunteer opportunities at Infirmary Health?
Do you have other friends or relatives who would be interested in volunteering?
Days preferred
Hours preferred
Would you be available to substitute on short notice?
List two personal references (minister, employers, etc.)
Infirmary Health | All Volunteers - Background Consent Form
Infirmary Health | All Volunteers - Consent for Health-related Tests
Mobile Infirmary | Teenage Volunteers - Program Information
Mobile Infirmary | Teenage Volunteer School Reference Form
I acknowledge that, if accepted, I will be volunteering of my own free will and do not expect any monetary compensation. I declare that all of the above statements are true to the best of my knowledge and any misrepresentation will be the cause for my rejection or dismissal. I understand that this application is not an offer of acceptance into the Volunteer Program. I also recognize that if I am accepted as a volunteer, Infirmary Health System reserves the right to make such changes in the terms and conditions of my volunteer services Infirmary Health System deems to be necessary and appropriate.
*Adult Volunteer Program: Please download the Background Check form as well as the Consent for Health-related form, enter your information, and upload below. *Teenage Volunteer Program: Please download ALL forms, enter your information, and upload below.

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Infirmary Health System Volunteer Application