Please complete this application form if you are interested in becoming a UPMC Centers for Rehab Services Volunteer. Once you complete the form, click the Continue button at the bottom.
DO NOT APPLY MORE THAN ONCE
This information is used only to help us get a better idea of the demographic make-up of our volunteers.
Do not choose more than TWO locations and indicate the days and time you are available.
In the event of an emergency, whom should we contact?
This information is required:
Are you a U.S. Citizen? Please indicate Yes or No below.
If you are not a citizen, current Visa and/or Passport documentation are required at your interview appointment.
Volgistics Volunteer Alerts sends reminders, alerts, and custom messages from System Operators and
Coordinators. Use this section to opt-in and opt-out of text messaging (also known as "SMS"),
and initially set how you would like to receive messages. Your messages can be delivered as emails,
text messages, or none. You can change this at any time through VicNet. View supported phone carriers.
Message and Data Rates May Apply. For help or information on this program send "HELP" to 28344.
You can send "STOP" to 28344 at any time to opt out. For additional assistance, call 888-891-6978 or
Message frequency based on account settings.
Messages are not guaranteed to be delivered. All messages will be sent by email until you respond "YES"
to the welcome text message sent after the application form is submitted. Message preferences
can be changed in VicNet on the Account tab.
I understand and agree that submitting this application form does not automatically register me as a UPMC Centers for Rehab 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.