Thank you for your interest in volunteer service at Norton Audubon Hospital. We will review your application and be in contact. If you have questions, please feel free to email Rondah Kinchlow at rondah.kinchlow@nortonhealthcare.org


Demographic Information and Non-Family References

Please provide your complete middle name, not an initial. Two references are required. References cannot be family members. Enter reference information in sections 1 and 2.


Personal Information

Please provide the following information. We are currently not accepting volunteers under the age of 18. Norton Healthcare does not accept applicants without a social security number.


Skills and Experience

Please list any pertinent skills and experience.


Scheduling

Please indicate the day(s) and time(s) you are available to volunteer.


Volunteer Positions

Use this list to rank your top three choices. We will discuss position availability during your interview.


Emergency Contact

In the event of an emergency whom should we contact?


Employer

Please list your current or most recent employer, if applicable.


Email

Please enter your email address.


Criminal Background Checks

Criminal background checks are performed on all applicants 18 and over. It can take up to two weeks to get a background check processed. You will be contacted once the background check is completed.


K-TAP and Court Appointed Service

Norton Healthcare does not participate in the K-Tap program or any program that mandates volunteer hours to obtain housing or child care, nor do we accept applicants who need community service mandated by the court system.


Why Are You Interested in Volunteering?


List Medical Conditions or Physical Limitations


I Agree

I understand that submitting this application does not guarantee a position as a Norton Audubon Hospital volunteer but if I am accepted the following requirements must be met: interview, orientation, criminal background check if 18 or older, reference checks, suitable placement, TB screening, Tdap & influenza vaccine (during flu season) and possible other lab work. Submission of this application affirms that I give permission for a criminal background check if I am 18 or older.

If under 18, I have the consent of my parent or legal guardian to volunteer at Norton Audubon Hospital. Teens must be 14 to apply for a volunteer position.

I consent that photographic images of myself may be used at the discretion of Norton Healthcare.

By submitting this form, I agree that the information I have provided is true and accurate.