Volunteer Service Online Application - Marwood Nursing and Rehab

Marwood Nursing & Rehab Volunteer Service Application

*Indicates required information

Contact Information

Address *

Which program are you interested in: *

How did you hear about us:

Education and Experience

Junior Volunteers - Age 14 - 18

Are you volunteering to satisfy community service for a school or university: *

Are you currently employed: *

Previous Volunteer - Work Experience

Have you ever been convicted of a felony: *

Are you volunteering to satisfy a court-required community service: *

Availability

Please indicate the day(s) of the week that you are able to volunteer if the Volunteer Department accepts your application. Shift times vary according to assignment.

Indicate the days and times available: *

Are you willing to work holidays: *

Position Desired

Direct patient contact: *

Special Skills/Interests/Hobbies

Language(s) including sign language - please specify:

Are you willing to serve as an interpreter:

Hobbies and special skills - please list:

References

I authorize an investigation of this application, agree to cooperate in such an investigation and release all liability or responsibility of all persons or entities requesting or supplying such information.

Marwood Nursing and Rehab offers equal opportunity to all based upon individual merit and without regard to race, color, religion, national origin, disability, age or gender. Marwood Nursing and Rehab is not obligated to provide placement nor is the applicant obligated to accept the volunteer position offered.

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