CAMC Employee Volunteer Application Form

Please complete this application form if you are interested in becoming a Charleston Area Medical Center volunteer. Once you complete the form, click the Continue button at the bottom.

Contact Information

Make sure you opt IN to email notifications. E-mail is the primary method of communicating to our volunteers. Please allow us to send you e-mails. You will not receive e-mails from anyone other than CAMC Volunteer Services. No one else will have access to your e-mail address.

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.

Age range:

Education:

Facebook

Are you on Facebook? We have a private CAMC Volunteer Facebook group. This group is used as an additional method of communication to our volunteers. Would you like to be included in this group?

Yes or No?

Emergency Contacts

In the event of an emergency, whom should we notify?

First name:

Last name:

Title:

Street 1:

Street 2:

Street 3:

City:

State:

Zip:

Home phone:

OK to call here

Work phone:

OK to call here

Cell phone:

OK to call here

Email address:

Relationship:

Interest

What would you be interested in doing as a volunteer? Office role? Patient interaction? Hospitality role? Arts activities? Other?

Skills

What kind of skills do you have that could be utilized as a volunteer at CAMC? Computer? Arts and Crafts? Interpersonal? Planning and Organization?

Employer

Please list your current or most recent employer, if applicable. (Question 1: Answer Yes or No if you are or have been a CAMC employee)

CAMC Employee ?:

First name:

Last name:

Title:

Street 1:

Street 2:

Street 3:

City:

State:

Zip:

Home phone:

Work phone:

Email address:

Availability

Please indicate the days and times you are usually available to volunteer. An important part of volunteering is commitment. Our volunteers play an important role in service to our patients, families, and staff. In order to provide the best service, we need our volunteers to be here on a regularly scheduled basis. Typically, we would like our volunteers to commit to at least 3 - 4 hours per week.

Orientation Schedule

As a CAMC employee, Volunteer Services will validate that you are up to date with your Annual Education and Employee Health information. We will discuss with you individually your need for orientation to the department/assignment that you choose.

Core Values

Tell me a little bit about yourself. Example: Goals, Interests, Hobbies Why are you deciding to become a volunteer? Have you ever volunteered before? When? Where? Have you every been employed before? When? Where?

Criminal History

As a prerequisite to acceptance as a volunteer is the completion of a criminal background check.

Have you ever plead guilty or 'no contest' to or been convicted of, violating any law with the exception of minor traffic violations?

If yes, please list your criminal convictions.

Anything else?

Please provide us with any additional information that will help us know more about you.

I agree

I certify that the answers given by me in the foregoing questions and statements are true and correct without consequential omissions. I understand and agree that any misrepresentation in my application will be sufficient cause for cancellation of the application and/or separation from the organization.

I understand that this is an application for volunteer services and not a contract to provide those services.

I will hold absolutely confidential all information which I may obtain directly or indirectly concerning patients, doctors or personnel. I will not seek confidential information in regard to a patient.

I give Charleston Area Medical Center, Inc. permission to make a thorough investigation that may include the following: past employment, past volunteer experiences, education, and criminal history. I authorize and release from liability or responsibility all persons, companies, schools and municipalities supplying any information regarding me whether or not it is a matter of record.

If selected as a volunteer, I understand that my services will be donated to CAMC Health System, Inc. without contemplation of compensation or future employment and given with humanitarian or charitable reasons.

I authorize CAMC Health System, Inc. to use and disclose information such as my name and photographs for the purposes of marketing, media and education.

As part of the volunteer onboarding process, I will be required to visit Employee Health for a health review and review of vaccinations. I will also be required to receive a flu shot annually. If you do not agree to these please do not submit this application.

I Agree