Adult Volunteer Application

Please complete this application form if you are interested in becoming a volunteer at San Antonio Regional Hospital located in Upland, CA.

When finished, click the continue button at the bottom.

Contact information

Please complete the following information. Required fields are identified by the asterisk (*) beside them.

First name:

Last name:

Middle name:

Street:

City:

State:

* Zip: *

Home phone:

Cell phone:

Email address:

Program of interest

Tell us which of the following programs you are interested in.

Program of interest:

Availability

Tell us when you can volunteer during the day. Please indicate your availability. Check all that apply.

Skills

Please complete the following information. Check all that apply.

Medical information

A variety of volunteer positions are offered at our hospital. Some require more physical stamina than others. To help us best match your skills and abilities to the needs of the hospital, we would appreciate you providing some additional information. The hospital works to provide reasonable accommodations for any disabilities as long as the safety of our patients and our volunteers is not jeopardized and the volunteer is able to perform the essential duties of the role.

Please select the option below that describes the type of role that best suits your needs.

Activity level:

Reason for volunteering

Please explain why you would like to volunteer at San Antonio Regional Hospital.

Additional experience

Please describe any other volunteer experiences you may have had.

Volunteer Application Statement

Please read the following:

I certify that all answers in this volunteer application are true and correct and have been given voluntarily. I understand that this information may be disclosed to any party with legal and proper interest and I release the agency from any liability whatsoever for supplying such information.

I understand that I am volunteering my services free of charge and do not expect monetary compensation of employment.

I understand that I will be required to attend additional orientation classes in order to be fully informed about health and safety regulations at San Antonio Regional Hospital.

I understand that I will have to authorize a background check before I can begin volunteering.

I understand that I will be required to have a health screening which includes a TB test and flu vaccination.

I give my consent to use my name and/or my photograph published on the hospital’s website, SARH.org, or the hospital’s social media properties.

I understand that I have to purchase a uniform.

I understand that the position requires me to volunteer a minimum of 100 hours.

I understand that by submitting this application, I am agreeing to all of the statements listed above.

I Agree