Thank you for taking the time to apply to become a Ranken Jordan Volunteer!

*Ranken Jordan typically hosts New Volunteer Orientation once per month. Due to the current precautions in place at the hospital in response to the pandemic, our next New Volunteer Orientation is not scheduled until 2022. We apologize for the inconvenience. We will reach out to all applicants as soon as we have a date for our next orientation.*

Please have a reference letter from a non-relative saved to your device before starting this application. Upon submission of the online application, you will receive an e-mail requesting your reference letter. Applications are not considered complete without a reference letter.

Applicant Contact Information

First name:

Last name:

Title:

Nickname:

Street 1:

Street 2:

Street 3:

City:

State:

* Zip: *

Home phone:

OK to call me here

Work phone:

OK to call me here

Cell phone:

* OK to call me here

Email address:

Referral Source:

Social Security Number:

Applicant Demographic Information

Date of birth:

Age:

Gender:

T-Shirt Size

Vehicle Information

Vehicle Year:

License Plate Number:

Vehicle Owner Name:

Vehicle Make:

Vehicle Model:

Vehicle Color:

Education

Education:

Employment

Enter Employer

What kinds of email would you like to receive?

Special Requests

Employer name:

Work phone:

Email address:

Name of company

Emergency Contact

First name:

Last name:

Home phone:

OK to call here

Work phone:

OK to call here

Cell phone:

* OK to call here

Relationship:

Reference

Please include the information of the reference you chose to write your reference letter.

First name:

Last name:

Cell phone:

Relationship:

Availability

My availability is:

From:

to:

Are you doing service hours for school?

Please include: school, total hours needed, date service hours need to be completed, and maximum hours you can serve each week.

Reasons for Volunteering

Tell us about your decision to start volunteering at Ranken Jordan.

Special Interests or Skills

Please share any personal information about yourself such as profession, hobbies, talents, expertise, etc.

Volunteer Expectations and Requirements

As a potential volunteer at Ranken Jordan it is important that you know and understand our expectations and requirements. Please review the following 12 statements and check the box if they are true or you can commit to them.

1. I am 16 or older.

2. I consent to Ranken Jordan completing a background check before I begin service.

3. I am fully vaccinated with the COVID-19 vaccine.

4. I agree to attend and complete a 3 hour Volunteer Orientation, Service area training, and 2 hour regulatory hospital training.

5. I can commit to a weekly shift of a minimum of two hours and maximum of four hours. I can commit to volunteering at least 40 hours. (3-5 month commitment)

6. I understand that I will not receive written confirmation of my service hours until I have served a minimum of 40 hours.

7. I will complete a TB skin test within 30 days prior to New Volunteer Orientation either from a private physician or from Ranken Jordan.

8. During flu season, I can provide proof of a yearly flu shot. If applicable, I can provide proof of allergy to flu shots.

9. I can and will purchase Ranken Jordan Volunteer apparel for a minimum of $10.

10. I will consider the children first in all that I do. My volunteer service will prioritize the patients, families, and facility.

11. I will be flexible and willing to do what it takes to provide support. I will be willing to work outside of my usual job description if needed.

12. I will be open and honest. I will communicate concerns to the appropriate staff members. I am comfortable asking for assistance, guidance, and direction when I need it.

To complete this application: I will submit a reference letter within 24 hours of submitting this application.

I Agree