Please complete this application form if you are interested in becoming a Avista Hospital volunteer. Once you complete the form, click the submit button at the bottom.
Who shall we contact in case of Emergency?:
Please select below your preferences for assignment(s). You can click your mouse on any assignment below to view its description, times, etc.
Please indicate the days/times you are usually available to volunteer:
What are you doing now?:
High School Student
College Student
Working Full Time
Working Part Time
Retired
Other (please explain)
Do you have any previous volunteer experience? If so, please explain:
How did you hear about our volunteer program at Avista?
Do you have an significant health problems (either physical or emotional) that should be considered in your placement? If yes, please explain:
Have you ever been convicted of any law violation other than a traffic violation? If yes, please explain:
Please provide 2 non-family references who will say you would be a good volunteer:
I understand and agree that submitting this application form does not automatically register me as a Avista Hospital 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 accurate.
