Thank you for your interest in volunteering at the Howard Phillips Center. We are very fortunate to have so many people who want to help us improve the health and quality of life of the individuals and communities we serve. We look forward to reviewing your application and assisting you in finding meaningful service opportunities. Please be sure to include a valid email address with your application (double check your entry) as this is how we will communicate with you. Thank you again for choosing the Howard Phillips Center.



Name and Address


Demographic Information


References

Please provide 3 references, one reference should be business or professional. Immediate family will not be accepted as a reference. All required information must be provided or your application will not be processed.


Emergency Contact


Work Status

Please provide your current work status, i.e, employed, homemaker, retired, student, looking for employment. If attending school, please provide school name.


Prior Employment/Volunteering at Orlando Health

Have you ever been employed by Orlando Health or any subsidiary and/or have you ever been a volunteer for Orlando Health. Please explain.


How Did you Become Interested in Volunteering

How did you become interested in volunteering at the Howard Phillips Center?


Availability

Please provide the days and times that you are able to make a regular commitment.


Placement Preference

Please indicate which volunteer opportunity you are interested in: The Healing Tree, Teen Xpress, Clerical support


Other Volunteer Experience


Skills, Interest

Please list any skills, interest, and/or hobbies that you would be willing to share as a volunteer.


Criminal Background History

Have you ever been convicted in a court of law, pleaded nolo contendere, been placed on probation or had adjudication withheld to an offense other than a minor traffic violation?


I Agree

I understand and agree that submitting this application does not automatically register me as an Arnold Palmer Medical Center volunteer. I also understand and agree that, as a condition of being selected as a volunteer at Arnold Palmer Medical Center, Orlando Health will conduct a background check, and that there are certain qualifications I must meet, including a tuberculosis test and drug screening. I understand that Arnold Palmer Medical Center and Orlando Health do not accept court-ordered community service volunteers.

By submitting this form, I attest that the information I have provided on the form is true and accurate.