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Volunteer Opportunities Form

 

World Wide Web users…application expressly for volunteer opportunities at St. Joseph Healthcare and St. Joseph Hospital, located in Bangor, Maine. If you are seeking a position at another healthcare facility named “St. Joseph”, please contact that facility for assistance. Thank you!

Personal Information
 
First Name:
Middle Name:
Last Name:
Address1:
Address2:
City:
State:
Zip: -
Home Telephone Number: ()-
Work Telephone Number: ()- x
   
Overview
 
How did you become interested in volunteering at St. Joseph Healthcare?
(Check all that apply)
Poster/Newspaper
ASPIRE
Referred by current volunteer
NOE
RSVP
Walk-in
Other 

What service areas are you interested in working as a volunteer?
(Check all that apply)
Escorting Patients
Dietary
Front Desk or Reception
Offices or Medical Records
Patient Services
Gift Shop
Other 

Please check the following skills you could provide to the Volunteer Services Department:
General Office
Filing
Typing
Mailings
Photocopying
Retail Sales
Housekeeping/Laundry
Customer Service
Public Speaking
Computer (please specify) 
Other 

How many hours are you interested in providing to St. Joseph Healthcare each week?
 
What days and hours during the week would you be able to volunteer?
 
Have you worked or volunteered at St. Joseph Healthcare in the past?
Yes No
   
If yes, in what capacity? Employee
  Adult Volunteer
  Junior Vonunteer
  Other:
  Position(s) held:
  Years:
   
Have you been convicted of a crime (please include moving violations)?
Yes    No
If yes, please explain:
   
Education
High School/GED  
School/Institution
Number of years completed:
Graduation: Yes    No

College/Technical School  
School/Institution:
Number of years completed:
Course of Study:
Degree Awarded:
   
References
Please list three people you have known for at least two years who could attest to your good character and/or work history. Please do not include relatives or minors (under 18). Please provide complete and accurate mailing addresses and telephone numbers for all references.
   
Reference 1  
Name:
Address:
City:
State:
Zip: -
Home Telephone Number: ()-
Reference: Character Reference
  Work Reference

Reference 2  
Name:
Address:
City:
State:
Zip: -
Home Telephone Number: ()-
Reference: Character Reference
  Work Reference

Reference 3  
Name:
Address:
City:
State:
Zip: -
Home Telephone Number: ()-
Reference: Character Reference
  Work Reference
   
Please read our volunteering terms carefully before submitting.
 
 
 

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