Please complete this application entirely if you are interested in becoming a member of the Volunteer Services Program for either Banner Gateway Medical Center or Banner MD Anderson Cancer Center. Once you complete the application, click the continue button at the bottom.

We are currently recruiting volunteers who are at least 16 years old and can commit to six (6) months or longer with the availability to volunteer one (1) regular shift of approximately 4 hours in length per week. Our onboarding process includes an interview, health screening, and background check and will take a minimum of three weeks to complete. If you are unable to meet any of these requirements at this time, please complete this application at a later date.


Applicant's Information

Provide the following information. An email is required for future communication(s).



Employment Status

If currently employed, provide employer's name.



Education


Volunteer Experience

Have you ever volunteered at Banner Health or have other volunteer experience?  If yes, when and where?



Interests

Why do you wish to become a Banner Health volunteer?

What are your hobbies/interests? 



Availability

If you are interviewed and offered a volunteer position, your availability to serve as a volunteer is very important. Indicate the days and times you are available to volunteer.



Emergency Contact Information

Please provide Emergency Contact Information.



Physical and Medical Background Information

Do you have any physical limitations or medical condition that may limit your ability to perform any volunteer duties? If "Yes", please explain below.



Background Check

Have you ever been convicted of a felony or a felony that was reduced to a misdemeanor for sentencing purposes including DWI? If yes, state the offense, location, date and disposition.


Commitment

By checking “I agree” and submitting my application, I am stating that, to the best of my knowledge, all information that I have provided is true and correct.

 I agree to:

  1. Comply with the confidentiality standards regarding all patient information.
  2. Provide my date of birth and social security number to verify and meet Banner Health’s reporting requirement that I have not been excluded from participating in any Medicare, Medicaid or other federal health care procurement program.
  3. Uphold the Mission, Values and Purpose of Banner Health.
  4. Endeavor to serve with compassion, empathy, accountability, responsibility, and excellence.

I understand that my services are donated to Banner Health without contemplation of compensation or future employment and given for humanitarian or charitable reasons. I also understand that there are many types of volunteer opportunities at Banner and that I will be required to complete an initial health screening, background check, orientation and training. I also understand that to continue volunteering, I may be required to comply with additional health screenings and trainings.



Acknowledgement

In submitting this application I agree to the terms outlined in the commitment of services and that all information is accurate.