Please complete this application form if you are interested in becoming a volunteer at UnityPoint Health - Trinity. Once you complete the form, click the submit button at the bottom. Once your application has been submitted you will receive an email within 3 days for further instruction. Completion of application does not guarantee placement.

**Please note, if you are under 18 you will need to fill out a teen application instead of this form. Please call our office at (309) 779-2211 to have one mailed to you.

Contact Information


Availability

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


Skills & Experience

In the section below, please summarize any relevant skills and experience that exemplify your background, including other volunteer or work experiences, patient care situations, computer/equipment skills, hobbies, and any other special qualifications, capabilities or interests you may have. you make also want to include any other languages you are fluent in (read, write and/or speak).


References

Please fill out the boxes below with two references (who are not related to you) who know you well and can answer questions regarding your character and abilities.


Emergency Contact

In the event of an emergency, please list two people that we can contact.


Special Projects

Are you willing to assist with special hospital projects outside of your regular volunteer hours?


Comments

Please let us know why are you interested in volunteering at UnityPoint Health - Trinity and how you found us.


How did you hear about us?

Let us know if someone referred you.


Background Check & Criminal Conviction

All volunteer applications will be submitted to a criminal background check, per hospital policy. By checking this box, you indicate that you have NOT been convicted of a crime AND that you do NOT have a record of founded child or dependent adult abuse.