Please complete this application form if you are interested in becoming a UPMC Volunteer and Community Services volunteer. Once you complete the form, click the submit button at the bottom.

** DO NOT APPLY MORE THAN ONCE **



Please scroll down to the "Availability" section before proceeding, as some programs are full and not accepting new applications.


If you have volunteered at one of the UPMC facilities in the last 2 years, there is no need to re-apply. Please notify the hospital Volunteer Department in which you were a volunteer.



Contact Information


Demographic Information

You may optionally provide the following information. It is used only to help us get a better idea of the demographic make-up of our volunteers. NOTE: Age requirements may vary by location.



FOR PA APPLICANTS ONLY

Have you lived outside PA. in the past 10 years?



Hobbies & Skills

List your hobbies and any skills that would help you in volunteering.

This includes language skills (read, write, speak, or sign).



Availability ** DO NOT APPLY MORE THAN ONCE **

PLEASE READ THE FOLLOWING INSTRUCTIONS BEFORE SELECTING A SITE



1. SELECT 1 (ONE) FACILITY * DO NOT SUBMIT MORE THAN ONE APPLICATION - BE SELECTIVE AND CHOOSE ONE SITE THAT WILL WORK BEST FOR YOU. DO NOT CHOOSE MULTIPLE SITES.


2. Hospital Elder Life Program (HELP) at UPMC Shadyside - (If you want to volunteer with HELP, select HELP as your site.)


3. UPMC Passavant (McCandless/Cranberry): Passavant is no longer accepting high school student applications. The program is closed.


4. Magee-Women's Hospital: The Cuddler Program is full and not accepting applications at this time.


5. WPIC-All positions for the upcoming semester have been filled.


6. UPMC Presbyterian - the Volunteer application window has closed for the spring session. Applications will reopen in March for the Summer session. Thank you! NODA volunteers should continue to apply year round. If anyone has questions, please call (412) 648-6105.



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




Type of Volunteer Work Preferred

List the types of work you prefer and indicate if you would like a position with patient contact.



Emergency Contact

In the event of an emergency whom should we notify?



Work & Volunteer Experience

Please list your most recent employer or volunteer experience, if applicable.



Reason for Volunteering

Why are you interested in volunteering?



Community Service

Have you applied for volunteer service to fulfill a school or court appointed community service requirement? If yes, please include explanation along with the number of hours required.



Violations

This information is REQUIRED: Have you ever pleaded guilty, been convicted of, accepted ARD or similar program, or pleaded no contest other than a summary offense? Please Indicate Yes or No. If yes, please describe.



Citizenship

This information is REQUIRED: Are you a U.S. Citizen? Please indicate Yes or No. If you are not a citizen, Visa and/or Passport documentation are required at your interview appointment.



I Agree

I understand and agree that submitting this application form does not automatically register me as a UPMC Volunteer and Community Services volunteer, and that there may be certain qualifications I must meet, including the acceptance of established volunteer policies and procedures before I may begin volunteering.

By submitting this form, I attest that the information I have provided on the form is true and complete to the best of my knowledge. I understand that any false statement, misrepresentation or omission may cause my dismissal from volunteer service.