Thanks for your interest in volunteering at The University of Vermont Medical Center. Please submit this application and we will notify you regarding next steps.


Personal Information


Demographic Information


Interests

Please select all areas of interest.



Employment History

Please list 1 recent employer or leave blank if you have no employment history.



Qualifications

Please check all applicable areas.



Availability

Please indicate the days and times you are available to volunteer. Volunteers are expected to make a 6 month commitment and work a minimum of 4 hours each week.



Emergency Contact Information

Please list one emergency contact.



Agreement

In being considered for a volunteer position at The University of Vermont Medical Center, I agree that The University of Vermont Medical Center and any references provided at the time of my interview may exchange information about my qualifications without incurring any liability.

Acceptance for volunteer placement is subject to:

1. Satisfactory reference and screening reports.

2. Personal interview with the Director of Volunteer Services or the Program Coordinator.

3. Willingness to abide by all organizational requirements and regulations.

I understand that The University of Vermont Medical Center is not obligated to provide placement, nor am I obligated to accept a position. To the best of my knowledge, the information provided in my application is true and complete. I understand that any misrepresentations or omissions of facts shall be considered sufficient cause for dismissal.