Volunteer Engagement

1001 S. George Street York, PA 17403

Phone: (717)851-2147 Fax:(717)851-3279

Email: volunteersvcs@wellspan.org


Applicant Information:

Please provide your legal name (i.e. no nicknames).



Community Service Requirement:

Please provide information if you are volunteering to fulfill a community service requirement, including the name of the school/organization, number of hours needed and deadline for completion.



Conviction Information:

Please provide details of your conviction information, including the type of offense, date and county.



Emergency Contact:


Volunteers Under the Age of 18:

If Volunteer applicant is under the age of 18, parent/guardian understanding of the following is required:

1. Gives permission for child to serve as a Book Nook warehouse volunteer.

2. Importance of child's punctuality and reliability.

3. Supports child's commitment to volunteer services.

4. Affirms the application is true and accurate.

5. Permits the use of child's photograph as a volunteer to be used for publicity purposes.

6. Understands that if child does not follow policies and procedures of Wellspan Health/Volunteer Services or does not present for scheduled volunteer shifts, child will be terminated.



If Under 18, Enter Parent/Guardian Information:


Agreement:

I hereby certify that all statements and answers set forth on the application are true and complete to the best of my knowledge. I understand that any statements and/or answers are found false or information has been omitted, may be cause for rejection or termination of my volunteer application or service. I understand that a condition of volunteering, WellSpan will request a background check consisting of a criminal history check. I understand that my consent will apply throughout my volunteer services with Wellspan to the extent permitted by law. I permit WellSpan Health to use my name, photograph or video as a volunteer for publicity purposes when necessary.