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Volunteer Form

Volunteer Signup Form

Please note: Unfortunately, we cannot accommodate people attempting to fulfill court-ordered community service requirements.

All fields with asterisk (*) are required.
Title

Enter phone number as xxx-xxx-xxx

Enter your date of birth in this format: mm/dd

Which one are you? *

Emergency Contact Information

Please list someone we can contact in case of an emergency.

Work Experience

(Important to complete for successful placement)

Please provide two recommendation letters

from someone (not a relative) who has known you for at least one year.
Upload Recommendation Letter Here:

This information is required

Upload Recommendation Letter Here:

This information is required

Do you have any physical/developmental concerns that might keep you from performing Volunteer tasks?

Please check availability and preferences

What is your residency status?
If Part-Time, which months are you available?
What type of assignment do you prefer:
Mornings 8am-12pm
Afternoons 12pm-4pm
Evenings 4pm-8pm
After Hours 8pm-8am
All applicants 18 years and older will undergo a background check.
I agree to comply with all policies and procedures, to support the mission of The Hospitals of Providence and to serve without expectation or promise of remuneration or compensation for my services.

Please enter date in this format: mm/dd/yyyy