MultiCare Health System

Volunteer Application

In addition to completing the online application, please complete the following documents and bring with you to your scheduled interview :

Parental Consent (for teens age 15-17)

Background Disclosure Statement

Reference Form


Personal Information

       First Name    Middle Initial

       Last Name

Email Address

       Day Phone    

Evening Phone


Age
  15 to 16 years old
  18 to 21 years old
  21 years or older


Where did you learn about our program?
  School
  Job
  Friend
  Other

Address
                Street       City    

                 State        Zip

Education

College (Please include school name, dates attended, years completed and degree)
  

 High School (Please include school name, dates attended, years completed and degree)
 

Other Schools Attended (Please include school name, dates attended, years completed and degree)
 


Current Employment/Volunteer Obligations

Occupation      

Employer/School, if any


Prior Work Experiences (to help Volunteer Services identify skill areas)

Jobs (Be sure to include company, dates and job title for each position)
 

Volunteer Work (Be sure to include company, dates and job title for each position)
 


 Volunteer Assignments (Please select your area(s) of interest)
  Patient Support
  Patient Information
  Office Support
  Entertainers
  Facility Support
  Infant and Child Services
  Crafting
  Gift Shops
  Other (View the Volunteer Assignment Guide)


Volunteer Location (Please select the facility location you would prefer)
  Tacoma Area Facilities ( Tacoma General, Allenmore, Mary Bridge Hospitals, Adult Day Health)
  MultiCare Gig Harbor Medical Park
  Covington MultiCare Clinic


Availability (Please check your preferences. Specific schedules get discussed in the interview.)

                                      
 Monday                                        
  Morning (8am-12pm)      
  Afternoon (12-4pm)
  Evening (4-8pm)
  Night (8pm-2am)

 Tuesday
  Morning (8am-12pm)
  Afternoon (12-4pm)
  Evening (4-8pm)
  Night (8pm-2am)

  Wednesday
  Morning (8am-12pm)
  Afternoon (12-4pm)
  Evening (4-8pm)
  Night (8pm-2am)
 Thursday
  Morning (8am-12pm)
  Afternoon (12-4pm)
  Evening (4-8pm)
  Night (8pm-2am)
  Friday
  Morning (8am-12pm)
  Afternoon (12-4pm)
  Evening (4-8pm)
  Night (8pm-2am)
  Saturday
  Morning (8am-12pm)
  Afternoon (12-4pm)
  Evening (4-8pm)
  Night (8pm-2am)

Sunday
  Morning (8am-12pm)
  Afternoon (12-4pm)
  Evening (4-8pm)
  Night (8pm-2am)



Other Comments
 
         

By signing I herby certify that I will follow all rules and guidelines of MultiCare Health System.  I will read and understand any and all policies and procedures related to my volunteer role.  I will consider as confidential all information that I may hear directly or indirectly concerning a patient, doctor, staff member or organization. I hereby certify that there are no willful misrepresentations or falsifications of any of the statements or answers to questions on this application.


Name __________________________________________     Date  ____________


 (You will be asked to sign and date your application at a scheduled interview) 


In addition to completing the online application, please complete the following documents and bring with you to your scheduled interview :

Parental Consent (for teens age 15-17)

Background Disclosure Statement

Reference Form

Please note that you application will be denied if submitted without the appropriate attachments listed above.