Application

If you are interested in volunteering at St. Vincent Charity Medical Center, please complete the application form. Or you can download a PDF of the form and MAIL to Volunteer Services

2351 E. 22nd Street
Cleveland, OH 44115
FAX to 216-694-4608
EMAIL to volunteer@stvincentcharity.com

Downloads

St. Vincent Charity Medical Center Volunteer Application

* Denotes Required Field

Personal Information
  1. ex. 216-123-4567
  2. ex. 216-123-4567
  3. ex. MM/DD/YYYY









Placement Preference






  1.  
     
Past Experience
Employment - Current or most recent employer
Education - Years of school completed

It is the policy of St. Vincent Charity Medical Center to recruit, place and train for all Volunteer Caregiver positions on the basis of qualification and prospective Volunteer's needs and Hospital's needs. No aspect of Volunteer Services shall be influenced by race, color, national origin, religion, gender, age, or a qualified physical or mental handicap. All decisions regarding Volunteer Services will be made solely upon the basis of the individual's interests and skills, and the requirement of user departments in the Hospital.

If accepted as a Volunteer Caregiver at St. Vincent Charity Medical Center, I understand my responsibility to keep in strict confidence all information regarding patients, physicians, and Caregivers, and realize that violation of confidentiality WILL result in my dismissal from the program. I also understand that violation of Volunteer Services Policies and Procedures may result in my dismissal from the program. I understand that if anything in this application is found to be false or misleading, I will be subject to dismissal at any time during my Volunteer service.

I understand and agree to abide by all annual training requirements, TB screening requirements and performance standards.

I certify that the information in this volunteer application is true and complete for all practical purposes. It may be verified by the facility or any affiliate. Should a volunteer position be offered and it is found that the information is significantly untrue, incomplete, or misrepresented, I understand and agree that the facility or its affiliates are relieved of all commitments pertinent to my volunteer placement and that I am subject to immediate discharge without recourse.

I understand that the facility reserves the right to require blood tests or urinalysis for alcohol or drug screening or to allow inspection of bags (including purses or briefcases) or parcels brought into or taken out of the facility. I understand that refusal to submit to urinalysis, blood tests or search, when requested, may result in termination of my volunteer status.

Signature:
  1. ex. MM/DD/YYYY

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