Thank you for your interest in volunteering for VCU Health! Complete and submit this form so that we will have it available for consideration during our next Application Review. We match volunteers with opportunities based on their talents and availability, and the current needs of VCU Health.

If we think we might be able to match you with a volunteer opportunity, we may contact you to discuss and to schedule an interview. If an assignment is agreed upon, an onboarding process will be required.

Name and Address

First name:

Last name:

Middle name:

Title:

Preferred Name:

Street 1:

City:

State:

* Zip: *

Home phone:

Work phone:

Cell phone:

Preferred phone:

Email address:

Gender:

Skills, Characteristics, and Interests

Please choose your top FIVE (5) skills and your top FIVE (5) characteristics that you are interested in sharing as part of your volunteer service.

Availability

What is your schedule availability? Indicate your preferred days and times:

Students

If you are taking classes, what school, college, or university do you attend?

Educational Commitments

If you are not a current student, do you plan on taking any classes in the next year?

Emergency Contact

First name:

Last name:

Home phone:

Work phone:

Cell phone:

Preferred phone:

Relationship:

References

Provide two references who are not related to you (not family members). These references may be checked by Volunteer Services.

1

2

First name:

Last name:

Home phone:

Work phone:

Cell phone:

Preferred phone:

Email address:

Referral

If you have been referred to us by a staff member/department, volunteer, or partner organization please share below.

Referred By:

History with VCU/VCU Health System

Do you have any current or former affiliation(s) with VCU or VCU Health System?

Choose the best description:

Comments:

Submit Your Application

In order to submit your application, check the box next to 'I agree' after the reading the statements below under Acknowledgment, then click the green 'Continue' button.

Please note that due to the volume of applications we receive, we are not able to respond to every application.

Acknowledgment:

I hereby apply to volunteer for VCU Health and confirm that the above information is true, complete, and provided freely.
I understand and agree that any falsification of information, regardless of time of discovery, may result in my ineligibility to volunteer.
I understand and agree that submitting this application form does not automatically register me as a VCU Health volunteer, nor does it guarantee me a position as a volunteer.
If I am offered a placement, I understand that I will be required to complete an onboarding process that will include criminal history check(s), orientation, and for most placements, a standard health screening.
I agree that if I become a volunteer, I will learn and comply with the regulations and requirements of the organization and uphold the commitment that I make.
By checking 'I Agree' below I acknowledge that I have read and agree to be bound by the above statements and conditions.

I Agree