Thank you for your interest in volunteering at Orlando Health. We are very fortunate to have so many people who want to help us improve the health and quality of life of the individuals and communities we serve. We look forward to reviewing your application and assisting you in finding meaningful service opportunities. Please be sure to include a valid email address with your application (double check your entry) as this is how we will communicate with you. Thank you again for choosing Orlando Health.

Placement opportunities at Arnold Palmer Medical Center vary due to interest often exceeding the number of volunteer positions available. If we are not able to offer you a volunteer position at the present time, we would encourage you to explore options at other Orlando Health hospitals.

Due to the current COVID-19 situation, we have temporarily suspended volunteering in the facility, but have opened the application process for future consideration and placement possibilities. While we do not have a definitive time frame for application review as of yet, we will be in contact with you as soon as we do. Thank you for your patience.

Name and Address

First name:

Last name:

Middle name:

Title:

Nickname:

Street 1:

Street 2:

Street 3:

City:

State:

* Zip: *

Home phone:

* OK to call me here

Work phone:

OK to call me here

Cell phone:

Email address:

Demographic Information

Date of birth:

Gender:

Education:

Marital Status:

Social security #:

References

Please provide 3 references, one reference should be business or professional. Immediate family will not be accepted as a reference. All required information must be provided or your application will not be processed.

1

2

First name:

Last name:

Email address:

Relationship:

3

First name:

Last name:

Email address:

Relationship:

Emergency Contact

First name:

Last name:

Home phone:

Cell phone:

Relationship:

Work Status

Please provide your current work status, i.e, employed, homemaker, retired, student, looking for employment. If attending school, please provide school name.

Prior Employment/Volunteering at Orlando Health

Have you ever been employed by Orlando Health or any subsidiary and/or have you ever been a volunteer for Orlando Health. Please explain.

How Did you Become Interested in Volunteering

How did you become interested in volunteering at either Arnold Palmer Hospital for Children or Winnie Palmer Hospital for Women and Babies?

Availability

Please provide the days and times that you are able to make a regular commitment.

Hospital Preference

If you have a preference to volunteer at either Arnold Palmer Hospital for Children or Winnie Palmer Hospital for Women and Babies, please list below.

Other Volunteer Experience

Skills, Interest

Please list any skills, interest, and/or hobbies that you would be willing to share as a volunteer.

Criminal Background History

Have you ever been convicted in a court of law, pleaded nolo contendere, been placed on probation or had adjudication withheld to an offense other than a minor traffic violation?

Answer yes or no in the text box provided. If yes, please explain in detail, including dates.

I Agree

I understand and agree that submitting this application does not automatically register me as an Arnold Palmer Medical Center volunteer. I also understand and agree that, as a condition of being selected as a volunteer at Arnold Palmer Medical Center, Orlando Health will conduct a background check, and that there are certain qualifications I must meet, including a tuberculosis test and drug screening. I understand that Arnold Palmer Medical Center and Orlando Health do not accept court-ordered community service volunteers.

By submitting this form, I attest that the information I have provided on the form is true and accurate.

I Agree