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 Orlando Health Arnold Palmer Hospital for Children and Orlando Health Winnie Palmer Hospital for Women and Babies varies 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.

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.

Agreement to Conduct a Background Check

I understand and agree that as a part of the application process to be considered for a volunteer position at Orlando Health Arnold Palmer Hospital for Children and/or Orlando Health Winnie Palmer Hospital for Women & Babies, Orlando Health will conduct a criminal background check.

By clicking the 'checked' box below, I acknowledge that this constitutes as my electronic authorization for Orlando Health or its agents to check my background. I waive and release Orlando Health and its agents from any and all claims I may otherwise have with respect to any such criminal background check.

I Agree