Please complete this application form if you are interested in becoming a Chatham-Kent Health Alliance volunteer.

We are building an applicant pool to be considered for openings beginning in January 2023. These may include assignments with our Hospital Elder Life Program, within Diagnostic Imaging, at the Information Desk, and more. You will be contacted about vacancies at that time.

Once you complete the form, click the submit button at the bottom.

Name and Address

First name:

Last name:

Title:

Street 1:

Street 2:

City:

Province:

* Postal code: *

Home Phone phone:

OK to call me here

Work Phone phone:

OK to call me here

Cell Phone phone:

OK to call me here

Email address:

What Encouraged You to Apply?

We would like to know what inspired you to apply to volunteer at CKHA. Was this opportunity suggested by a teacher, friend or staff member at CKHA? Did you learn about it through a presentation or from a story on social media, TV, radio or in print? Did you seek this opportunity on your own?

Please tell us how you learned about volunteering at CKHA:

Why CKHA?

At CKHA, volunteers are an important part of the circle of care as they provide quality and continuous support to patients, families and staff.

Why do you want to volunteer at CKHA?

Related Experience

Do you have experience working with the public, or in customer service?

Please describe any applicable work, education or volunteer experience:

Employee & Volunteer Experience at CKHA

Are you, or have you ever been, an employee or volunteer at Chatham-Kent Health Alliance?

Please provide details here:

Demographic Information

You may optionally provide the following information. It is used only to help us get a better idea of the demographic make-up of our volunteers.

Date of birth:

(year optional)

Gender:

Profession status:

Availability

Please indicate the days and times you are usually available to volunteer. We are recruiting volunteers for shifts between 8AM and 8PM on all days of the week.

Additional Information

Is there anything else you feel we should know when considering your application to volunteer?

Please provide details here:

Agreement

I understand that my application does not guarantee me a position at Chatham-Kent Health Alliance (CKHA).

I understand that if selected to become a CKHA volunteer, I will be required to complete the orientation process including, but not limited to, providing a Police Background Check, undergoing a Health Review and attending an orientation session.

I hereby certify that all information included in this application form is true and complete.

I Agree