Dear Prospective Volunteer,

Thank you for your interest in volunteering for St. Luke's Health System. We are fortunate to be a part of a community where volunteering is highly valued. St. Luke's volunteers generously commit to serving 4 hours for most services, once weekly, for a minimum of one year or 100 hours. Before completing the online application, please note the following:

OUR SELECTION PROCESS INCLUDES A BACKGROUND CHECK & HEALTH SCREEN, AS ALL VOLUNTEERS ARE REQUIRED TO HAVE ANNUAL FLU SHOTS AND THE FIRST TWO COVID VACCINES. IN ADDITION, VOLUNTEERS SUBMIT TO A T-SPOT TUBERCULOSIS TEST (REQUIRES BLOOD DRAW), AS WELL AS DEMONSTRATE IMMUNIZATION TO MEASLES, MUMPS, RUBELLA (MMR), TETANUS, DIPHTHERIA, PERTUSSIS, (TDAP), VARICELLA, (CHICKEN POX). NO EXEMPTIONS ARE ACCEPTED.

To comply with State & Federal regulations, volunteers provide their social security number & date of birth to St. Luke's Human Resources department. In addition, comprehensive service training and orientation are provided. We also ask for a $20 donation to cover some of the cost of the volunteer uniform issued if you are selected to serve. Your application will be on file for six months with your specified site.

Please complete this application form if you are over the age of 18 and are interested in becoming a St. Luke's volunteer for our McCall location. Once you complete the form, click the submit button at the bottom.

Again, thank you for your interest in becoming a volunteer at St. Luke's.

The Volunteer Services Team

Demographic and Personal

You must be over 18 yrs of age.

Date of birth:

Gender:

Education:

Contact Information

First name:

Last name:

Street 1:

Street 2:

City:

State:

* Zip: *

Home phone:

Cell phone:

Email address:

Availability

Please indicate the days and times you are usually available to volunteer.

Emergency Contact

First name:

Last name:

Home phone:

Relationship:

Criminal History

St. Luke's completes a background check on all volunteers prior to serving at any of their facilities. Have you, at any age, ever been convicted of a crime (including withheld judgements, or other plea agreements, and any pending charges)? Crimes include: felonies, misdemeanors, traffic violations, etc. Answering "yes" does not automatically exclude you from volunteering.

YOU MUST TYPE "YES" OR "NO" IN THE BOX TO THE RIGHT. If yes, or not sure, please explain.

Volunteer History

Please list previous volunteer experience:

Expectations

Why do you want to volunteer for St. Luke's?

Current or Former Employee

Have you ever volunteered for or been employed by St. Luke's?

If yes, when and what position:

If you are accepted as a volunteer for St. Luke's, all information that you receive is confidential and not to be disclosed without the appropriate consent by St. Luke's. Any breach of confidentiality may result in termination of your service as a volunteer.

**I AGREE TO A MANDATORY ANNUAL INFLUENZA VACCINATION**

I Agree