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Hamilton Physician Group

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Volunteer at Hamilton
Current Volunteer Positions Needed
Anna Shaw Children’s Institute Volunteer Application

Anna Shaw Children’s Institute Volunteer Application

Date
MM slash DD slash YYYY
Name * Required
First Last
Type of Application: * Required
- Adutl (18+)
- Teen
Address * Required
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email * Required
Phone * Required
High School * Required
Graduate Year * Required
College
Degree
Current Employer
Shift Hours
Position
I'm interested in volunteering: * Required
- General Errands
- Gift Shop
**All volunteers must have the pertussis vaccine.
EMERGENCY CONTACT * Required
First Last
Phone * Required
Alternate Phone
Relationship
Name of Physician
Physician Phone
Languages Spoken * Required
- English
- Spanish
- German
- French
- Tagalog
- Other*
*Other language(s) spoken
Have you volunteered at Hamilton in the past?
- Yes
- No
When?
Other volunteer experience:
What are your hobbies, skills, & talents?
Best way to contact you? * Required
- Phone
- Email
It is policy of Hamilton Health Care System (HHCS), as a condition of volunteering that all Volunteers shall be immune to influenza. If you are unable to receive the flu vaccine you will need to fill out the vaccine exemption request form seasonal influenza. If the exemption is approved you must wear a mask and alternate badge ID while in the hospital during flu season November 1st through March 31st. Volunteers of HHCS are subject to random drug screening. Non-Family References (please give complete information)
Non-Family Reference #1
First Last
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Non-Family Reference #2
First Last
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Our volunteer schedule offers several options, please mark your preference by checking the boxes next to the day and time slot you would like to volunteer:
10:00am-1:00pm
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
1:00pm-4:00pm
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
Several positions require moderate physical strength and/or excessive walking. Do you have physical limitations or are you under treatment that may limit your ability to perform in a voluntary capacity? * Required
- Yes
- No
THE ABOVE INFORMATION IS CORRECT AND ACCURATE TO THE BEST OF MY KNOWLEDGE. I UNDERSTAND THAT VOLUNTEER POSITIONS ARE NOT COMPENSATED FOR THE TIME OR SERVICE DONATED. * Required
- True
- False
Hamilton Medical Center request a minimum one-year commitment with an agreement to serve a minimum of four (4) hours per week.
I give my consent for pre-placement testing, which may include chest x-ray, urine drug screen, TB screening, blood testing and/or other testing as deemed necessary. I also give my permission to Hamilton Health Care System to administer any first aid and/or medical treatment deemed necessary in the case of injury or illness suffered during the course and scope of service.
Please sign by typing your full name. * Required
Comments
This field is for validation purposes and should be left unchanged.

HAMILTON MEDICAL CENTER ALONG WITH ANNA SHAW CHILDREN’S INSTITUTE IS NOT OBLIGATED TO PROVIDE A PLACEMENT, NOR ARE YOU OBLIGATED TO ACCEPT THE POSITION OFFERED. OPPORTUNITIES ARE PROVIDED TO APPLICANTS WITHOUT REGARD TO RACE, RELIGION, CREED, NATIONAL ORIGIN, AGE OR SEX.