WVU Work-Study

Only complete this application if you have been accepted for work-study through WVU Student Financial Support & Services.

After applying, please complete your orientation at www.wvumedicine.org/volunteer-orientation. After completing online orientation, you will be contacted with further instructions.

Please contact Nancy Beckner at becknern@wvumedicine.org if you have any questions. Thank you!

Name and address


We require two PROFESSIONAL references. Please do not use family members. Once you submit your application, we will share the reference form with you.

WVU Hospitals Criminal Background Check Process


WVUH has a strong commitment to the safety and health of its patients, employees, physicians, and visitors. Ensuring that WVUH hires qualified persons is an important part in maintaining a safe environment. The Criminal Background Check process is conducted to verify the accuracy of the information provided by each person who works for WVUH. Therefore, as a condition of new and ongoing employment, all information required by the Criminal Background Check Process must be fully disclosed.

Criminal Background Check Process:

Please list all criminal convictions, pending charges, and charges to which you plead guilty or no contest since you were 18 years of age. This includes all felony and misdemeanor matters. Include any appearances before a judge, magistrate, or other court officials where you were required to pay restitution or fine in connection with a criminal matter. If you are in doubt about whether a matter should be noted on the form, please list it. Examples of the types of criminal matters that must be disclosed include the following:

Driving Related Offenses such as Driving under the Influence (DUI)

Driving with Suspended License

Non-payment of Child Support



Domestic Battery


Contributing to the delinquency of a minor

Public intoxication



Unlawful taking of vehicle/joyriding

Disorderly conduct

Drug Related Offenses

Making/issuing worthless checks

Please note that this is not an all inclusive list of criminal matters that must be disclosed.

Statement of Criminal Record Declaration

Complete this section ONLY if you are 18 or older.

Current charges

Complete this section ONLY if you are 18 or older.

Previous cities, states, and countries

Complete this section ONLY if you are 18 or older.

I, the applicant, hereby agree to the following:

Hold as absolutely confidential all information, which I may obtain directly or indirectly concerning patients, doctors or personnel and I will not seek confidential information in regard to a patient.

My services are donated to WVU Medicine-West Virginia University Hospitals, Inc. (WVUH) without contemplation of compensation or future employment and given with humanitarian or charitable reasons.

I hereby authorize West Virginia University Hospitals, Inc. (WVUH) to obtain, investigate and verify all information contained in this application for the purpose of evaluating my application for volunteering, for obtaining any regulatory approvals that may be required of WVUH in order for me to volunteer, and for any other purpose within the reasonable discretion of WVUH.

I understand that references will be sought by WVUH regarding previous work and educational background and that my answers to the above questions are subject to verification.

I understand and agree that any false or misleading statement(s) or the failure to include any material information requested on this application may be cause for WVUH to refuse to further consider my application for volunteer purposes, to revoke an offer to volunteer or to terminate my volunteering with WVUH.

I understand that my volunteering is dependent upon satisfactory completion of required immunizations. I understand my volunteering may be dependent upon the results of a criminal background check.

I understand that neither this application nor any other aspect of the application process, including any interviews that may be granted is intended to create a contract between WVUH and me for employment, volunteering, or for the providing of any benefit. If a volunteer relationship is established, I understand that

I have the right to terminate my volunteer relationship at any time and that WVUH retains the same right..

If I am selected to volunteer by WVUH, this authorization shall remain in effect for the duration of my volunteering.

I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement.

If I am convicted of a crime other than a minor traffic violation after being hired as a volunteer, I will report this information in writing to Volunteer Services within 48 hours.

I hereby certify that my answers to the above questions are true, complete, and correct.

Filing an application does not assure placement since the number of applicants usually exceeds the number of available openings. The director of Volunteer Services will choose applicants based on the interview and qualifications in keeping with the best interest of the hospital.

Falsification of information on this application is grounds for dismissal from our program.

All qualified applicants will receive consideration and will not be discriminated against on the basis of disability, veteran status, or other protected status.

If I am hired as a volunteer, this authorization shall remain in effect for the duration of my volunteer service.