Please complete this application form if you are interested in becoming a Valley Children's Healthcare volunteer at our Madera location only. Once you complete the form, click the Continue button at the bottom of the page.


HEALTH SCREENING REQUIREMENTS

I have read through and understand the health screening requirements; as posted on the website. I am able to provide written documentation of the TB health screening for tuberculosis; completed within the last 12 months. Valley Children's Hospital requires a 2–step TB test process and will provide the second TB skin test on site at no cost to you.






APPLICANT INFORMATION


AREAS OF INTEREST

Please indicate all volunteer roles you are interested in filling:



AVAILABILITY

Please indicate all days and times you are available to

volunteer:



HIGH SCHOOL EDUCATION

If the name of your high school does not appear in the drop down list, please enter the name in the box provided



PERSONAL STATEMENT

Using the box provided below, please tell us in a few sentences why would you like to become a Valley Children's Healthcare volunteer.



EMPLOYMENT AND/OR VOLUNTEER EXPERIENCE


SKILLS & EXPERIENCE

Do you have any special talents or skills that you would like to share with us? Please click all that apply.



EMERGENCY CONTACTS


APPLICANT'S PLEDGE

I certify that answers by me to the foregoing questions and statements are true and correct. I agree to a health screening and understand that placement in the Volunteer Services program at Valley Children's Healthcare is contingent upon successfully passing the health screening. I also understand that falsification or material omission of facts on this application may result in the rejection of my application or my dismissal. I understand that all candidates selected for the volunteer program (of legal age) will have to submit to a background check. I hereby release them and Valley Children's Healthcare from any and all liability for issuing, receiving, and using any such information. I agree that, if accepted, I will abide by the philosophy and all policies and procedures established by Valley Children's Healthcare. I further understand that either the organization or I can terminate my role as a volunteer for any reason.

I understand and agree that submitting this application form does not automatically register me as a Valley Children's Healthcare volunteer, and that there may be certain qualifications I must meet, including the acceptance of established volunteer policies and procedures before I may begin volunteering.