Please complete this application form if you are interested in becoming a volunteer at Great River Health Systems. Once you complete the form, click the continue button at the bottom.


Requirements for volunteering include the following:

Criminal and Sex offender background checks

State Dependent and Child Abuse

Health Assessments

TB Skin Testing

Dress Code

Orientation


We reserve the right to add/change this list as necessary.


Thank you for your interest in volunteer at Great River Health Systems!


Name and address


Demographic Information


Education History


Employment History

Please list your current employement history.



Previous Volunteer Experience

Please share any current or previous volunteer work you've done.



Availability

Please indicate the days and times you are usually available to volunteer.



Personal References

Please list up to 3 personal or professional references (not relatives) with their phone number and/or email address. Supplying this information gives Volunteer Services permission to contact those individuals listed as references to obtain information deemed relevant.



Emergency Contact Information

In the event of an emergency whom should we notify?



Why do you have a desire to volunteer?

Please share why you have a desire to volunteer at Great River Health Systems.



Criminal Offenses

Do you have a record of founded child or dependant adult abuse in this state or any other states?

If yes, please give dates and explain.



Criminal Offenses

Have you ever been convicted of a felony in this state or any other state?

If yes, please give dates and explain.



I Understand and Agree

I hereby authorize the Volunteer Services Department at Great River Medical Center to investigate my past and to ascertain any and all information, which may concern my work and volunteer records, educational history and character. I also authorize Great River Medical Center to investigate all statements contained in this application to include criminal, and child and dependent-adult abuse information as well as my character and qualifications. I hereby release Great River Health Systems, its Volunteer Services Departments and all employees at Great River Health Systems of any damage whatsoever for issuing same. I further authorize the Volunteer Services Department to maintain this information in their records, release, and absolve them from all liability for acts performed in good faith and without malice in connection with the evaluation of my application.

Disclaimer: Because we take our responsibility seriously, we screen all our applicants thoroughly. While we try to place every prospective volunteer, management reserves the right to reject any applicant.