Partners of CRH Membership Form
Thank you for your interest in becoming a member of Partners of Crossing Rivers Health. Please complete this form. Then click "Continue" at the bottom.
Once your application has been accepted, a member of our team will contact you regarding your level and areas of interest.
Contact Information
First name:
Last name:
Title:
Choose
Dr.
Mr.
Mrs.
Ms.
Street 1:
Street 2:
Street 3:
City:
State:
Choose
FL
IA
WI
Zip:
Home phone:
OK to call me here
Work phone:
OK to call me here
Cell phone:
OK to call me here
Email address:
Demographic Information
Everyone should complete this section.
Date of birth:
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
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Sep
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Dec
Day
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2023
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*
Please check level of interest:
If you wish to be a Contributing Member only, this is the last section of this application you will need to complete. You may then skip to the "I Agree" section at the bottom.
Level of Interest:
Active Member
Community Member
Contributing Member (Partners only)
Community Events and Projects
If you wish to volunteer from home or one time intermittent projects, this is the last section of this application you will need to complete. Please check any fundraisers, projects and events you are interested in. You may then skip to the "I Agree" section at the bottom.
Projects & Sewing:
Baby's First Books
Children's Pillow
Comfort Care Pillow
Cotton Baby Hats
Crochet Baby Hat
Crocheted Baby Mittens
Fleece Blanket with Crocheted Edges
I have other ideas
Knitted Baby Hat
Mammo Capes
Memory Huggables
No Sew Fleece Blanket
PURPLE Hats
Sleep Masks
Teddy Bear
Fundraisers & Events:
Bake Sales
Blood Drives
Book & Gift Fairs
'Christmas Right Here'
Foundation Gala
Foundation Golf Classic
Geranium Sales
Hospital Week Events
Jewelry Sales
Lights for All Seasons
Nutman Sales
Season of Lights/Walk of Stars
Tree Lighting Ceremony
Uniform Sales
Active Volunteers
If you wish to volunteer IN our facility, please complete the remainder of this application.
Volunteer Opportunities:
Fundraisers & Events
Gift Shop
Hospice
Partners of Crossing Rivers Health
Projects & Sewing
Scholarship Committee
Way Finder
Assignmennt Preference
Assignment Preference:
1st choice:
Choose
American Red Cross Blood Drive [Community Projects & Events]
Book & Gift Fair [Fundraisers]
Gift Shoppe Clerk [Jerry's Gift Shoppe]
Hospice-Bereavement [Hospice]
Hospice-Office Work & General Tasks [Hospice]
Hospice-Special Projects [Hospice]
Hospice-Visitor Volunteer [Hospice]
Scholarship Committee [Partners of CRH]
2nd choice:
Choose
American Red Cross Blood Drive [Community Projects & Events]
Book & Gift Fair [Fundraisers]
Gift Shoppe Clerk [Jerry's Gift Shoppe]
Hospice-Bereavement [Hospice]
Hospice-Office Work & General Tasks [Hospice]
Hospice-Special Projects [Hospice]
Hospice-Visitor Volunteer [Hospice]
Scholarship Committee [Partners of CRH]
3rd choice:
Choose
American Red Cross Blood Drive [Community Projects & Events]
Book & Gift Fair [Fundraisers]
Gift Shoppe Clerk [Jerry's Gift Shoppe]
Hospice-Bereavement [Hospice]
Hospice-Office Work & General Tasks [Hospice]
Hospice-Special Projects [Hospice]
Hospice-Visitor Volunteer [Hospice]
Scholarship Committee [Partners of CRH]
4th choice:
Choose
American Red Cross Blood Drive [Community Projects & Events]
Book & Gift Fair [Fundraisers]
Gift Shoppe Clerk [Jerry's Gift Shoppe]
Hospice-Bereavement [Hospice]
Hospice-Office Work & General Tasks [Hospice]
Hospice-Special Projects [Hospice]
Hospice-Visitor Volunteer [Hospice]
Scholarship Committee [Partners of CRH]
5th choice:
Choose
American Red Cross Blood Drive [Community Projects & Events]
Book & Gift Fair [Fundraisers]
Gift Shoppe Clerk [Jerry's Gift Shoppe]
Hospice-Bereavement [Hospice]
Hospice-Office Work & General Tasks [Hospice]
Hospice-Special Projects [Hospice]
Hospice-Visitor Volunteer [Hospice]
Scholarship Committee [Partners of CRH]
6th choice:
Choose
American Red Cross Blood Drive [Community Projects & Events]
Book & Gift Fair [Fundraisers]
Gift Shoppe Clerk [Jerry's Gift Shoppe]
Hospice-Bereavement [Hospice]
Hospice-Office Work & General Tasks [Hospice]
Hospice-Special Projects [Hospice]
Hospice-Visitor Volunteer [Hospice]
Scholarship Committee [Partners of CRH]
7th choice:
Choose
American Red Cross Blood Drive [Community Projects & Events]
Book & Gift Fair [Fundraisers]
Gift Shoppe Clerk [Jerry's Gift Shoppe]
Hospice-Bereavement [Hospice]
Hospice-Office Work & General Tasks [Hospice]
Hospice-Special Projects [Hospice]
Hospice-Visitor Volunteer [Hospice]
Scholarship Committee [Partners of CRH]
8th choice:
Choose
American Red Cross Blood Drive [Community Projects & Events]
Book & Gift Fair [Fundraisers]
Gift Shoppe Clerk [Jerry's Gift Shoppe]
Hospice-Bereavement [Hospice]
Hospice-Office Work & General Tasks [Hospice]
Hospice-Special Projects [Hospice]
Hospice-Visitor Volunteer [Hospice]
Scholarship Committee [Partners of CRH]
Availability
In general, volunteers work a 4-hour shift. Please indicate the days and times you are usually able to volunteer.
Mon
Tue
Wed
Thu
Fri
Early morning 6-8:
Morning 8:30-12:30:
Afternoon 12:30-4:30:
Early evening 4:30-7:
Email Preferences
We like to keep volunteers informed of important news, schedules, and volunteer opportunities by email; however will not send you any email you prefer not to receive. Use the checkboxes below to select the kinds of email you would like to receive from us.
What kinds of email would you like to receive?
Electronic newsletters
Recruitment appeals
Important Information
Volunteer Group Update
Continuing Education
Schedule reminders
Checklist reminders
I Agree
I authorize full and complete investigation of my application information. This process may include interviewing professional and personal references, criminal history verification, and other relevant processes. I understand that any misrepresentation or falsification of this application may constitute rejection or dismissal.
In addition, I do hereby agree to indemnify and hold harmless Crossing Rivers Health, its employees, volunteers or agents from any and all claims or causes of action that may arise out of performance of my assigned duties as a volunteer. I waive any right I have against Crossing Rivers Health in consideration of my participation as a volunteer for the programs and offices of Crossing Rivers Health. In closing, I agree that my volunteer services are donated to Crossing Rivers Health without contemplation of compensation or promise of future employment.
I Agree
Continue