Please complete this application form if you are interested in becoming a WakeMed Health & Hospitals volunteer. Once you complete the form, click the submit button at the bottom.


Personal Information


We Like To Know


Why Are You Interested In Volunteering?


Interest


Skills and Experience


Assignment Preference

The following volunteer assignments are currently available. You may click on "Opportunities" from the WakeMed Volunteer website to learn more about these assignments. Use this list to rank your top assignment choices.



Availability

Please indicate the days and times you are usually available to volunteer. (Very limited weekend opportunities)



Criminal History

Your response to any of these security questions will not automatically disqualify you from volunteering. However, if you answer "no" and a criminal history is found or if you answer "yes" but did not include all convictions you will be disqualified from consideration.


Have you ever been convicted (pleaded guilty or been found guilty) of a misdemeanor of felony? Provide dates and details for any and all convictions and pending cases in the box below. Including, but not limited to, major traffic violations, writing bad checks and DUI.



Employment/Volunteer Information

Starting with your most recent position, list positions and activities including self-employment, volunteer work, and all significant experience.



Emergency Contacts


Demographic

Optional: The following information is used only to help us get a better idea of the demographic make-up of our volunteers.



Applicant Agreement

• I certify that the information contained in this application is correct and complete to the best of my knowledge.

• Acceptance as a volunteer at WakeMed is contingent upon satisfactory completion of all pre-placement procedures which include, but are not limited to, an interview, verification of references, criminal background investigation, orientation, immunizations, tuberculosis screening and annual flu vaccine.

• I realize that misrepresentation of facts will be cause for rejection of this application. In the event of placement in the volunteer program, falsification of any information on this application will be cause for dismissal.

• I authorize WakeMed to thoroughly investigate the information provided on this application and to conduct a Criminal Background Investigation. I will hold no person liable for giving or receiving information in this process.


I UNDERSTAND THAT IF I AM ACCEPTED AS A VOLUNTEER:

• I agree to abide by the policies of WakeMed and observe all hospital regulations.

• I understand that upon both my successful completion of the volunteer placement processes required by WakeMed and the receipt of approval for service by Volunteer Services management, I will become a volunteer.

• As a volunteer, I acknowledge that I will not receive compensation for services and I will not be required to work.

• I acknowledge that I will receive a placement description to specify the department(s) I will be volunteering in prior to my placement(s). A signed copy of that (those) placement description(s) will be in my volunteer personnel file.

• Photos taken while participating as a WakeMed volunteer or at special functions may be used for promotional reasons and for ID badge picture.


Submitting this form is your electronic signature and your acceptance of the Agreement above