Volunteers are vital in helping to assure that quality health care is available to those living in the communities we serve.


Once your application has been received, you will receive an email with a link to fill out necessary forms and to schedule a phone interview session and orientation. During the interview session, the volunteer opportunities will be discussed with an attempt to match your interests and time available. Once the orientation has been attended, an assignment is given and volunteering can begin.


Personal Information

Please provide the following information so we can contact you. Please note, you must be at least 14 years old to volunteer.



Volunteer Information

Why Beebe? Please let us know why you have chosen Beebe to volunteer and what you are interested in doing. Have you previously served as a volunteer at Beebe Medical Center? If so, when and where. Are there any other organizations that you volunteer with?



Availability

Please let us know what your availability would be so we can better match an opportunity for you.



Skills and Interests

Please provide your interests and any skills you would like to share.



Auxiliary/Fundraising

The following volunteer opportunities are Auxiliary positions and we ask that you join the Auxiliary first. There is a nominal, annual fee of $10 for membership.



Education, Work and/or Military Experience

Please share your education, work and/or military experience.



Personal References

List at least two (2) references who are not relatives.



Emergency Contact Information

Please provide the name, address and telephone number of someone that we can contact in case there is an emergency.



ALL PERSONS SEEKING VOLUNTEER PLACEMENT:

WITH A HEALTH CARE FACILITY ARE REQUIRED TO READ AND SIGN THIS ACKNOWLEDGEMENT. THIS IS ACCORDING TO THE STATE OF DELAWARE REGULATIONS: Special Employment Practices Regulations Relating to Health Care Facilities (19 Del. C. 708 and 11 Del. C. 8563 and Adult Abuse Registry Check (11 Del. C. 8564)

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Have you ever been involved in the substantiated abuse or neglect of children or adults under the laws of Delaware or any other state in the United States? Please answer YES or NO. If yes, please explain:




Disclaimer

Are you, or have you ever been, subject to exclusion or debarment under Federal law, or designated in a state abuse registry (including any nurse aid registry) as having a finding concerning abuse, neglect, mistreatment or misappropriation of property? Please answer YES or NO. If yes, please explain:



Convictions

Have you ever been convicted of, or plead guilty to a crime other than a misdemeanor or traffic violation?, If no, state No. If yes, please explain. An answer must be provided or application cannot be processed.



CAREFULLY READ THIS PRIOR TO SIGNING BELOW:

I authorize a full release for Beebe Medical Center to obtain information from my current and/or previous employer(s). I attest that the information I have given on the application (and accompanying resume, if any) represents a full and complete disclosure of information about my employment history, and that all information contained in the volunteer application is true and complete to the best of my knowledge and belief. I understand that failure to provide a full and complete disclosure is a violation of the law and, as such, is subject to civil penalties in the form of a fine. I understand that any false or misleading representation or omission made on the application during the volunteer interview process may disqualify me from further consideration for volunteering and may result in discharge even if discovered at a later date.


I understand that volunteering is conditional upon successfully passing the Adult, Child Abuse Registry and Criminal background check. Understand that should my position require it, Beebe Medical Center may obtain a copy of my driving record.


I understand that my volunteering is at-will which means that I may terminate the volunteer relationship at any time and for any reason with or without notice, and that the facility has the same right. I understand that no one has the authority to enter into any agreement contrary to the preceding sentence, except for a written agreement signed by an administrative representative of this facility and notarized.