Humber River Hospital

Please fill out all required fields. Thank you!

Year-Round Volunteer Program Application

Are you willing to volunteer at another site if your first choice isn't available?
Volunteer Type:
Requested Site:
Yes
No
My Information:
First Name:
Last Name:
Home Address:
Unit or Apt. #:
City:
Province:
Postal Code:
Home Phone:
Mobile:
Work Phone:
E-mail:
Additional Languages Spoken:
Gender:
Are you 16 years of age or older? *Must be 16 years to volunteer*
Yes
No
Please choose an age range:
Date of Birth: MM/DD/YEAR (OPTIONAL):
Yes
No
If yes, please explain:
Do you have any special considerations/limitations that you would like us to be aware of?
Have you ever been convicted of a criminal offense for which a pardon has not been granted?
Yes
No
Emergency Contact:
Contact Name (First and Last):
Relationship to you:
Phone Number:
E-mail Address:
I Want to be a Humber River Volunteer Because:
Please share your reasons for wanting to join the Volunteer Program at Humber River:
Please indicate the skills, talents and qualities you wish to share (i.e. music, art, computer, language):
Please indicate the characteristics and qualities you wish to share:
As a Humber River Volunteer how would you enhance the experiences of our patients?
My Availability:
Volunteers provide a commitment of 3-4 hours each week on a set, regular schedule for a minimum of one year. The availability options listed below are guidelines; actual start and end times will vary depending on the volunteer role.
Please check ALL of the days and times that you would be available for volunteer service.
Mondays
Tuesdays
Wednesdays
Thursdays
Fridays
Saturdays
Sundays
I am Interested in Helping With:
Inpatient Units: visiting & comforting patients, recreation activities, mealtime assistance
Outpatient Clinics: welcoming & escorting patients, visiting with patients in treatment, liaise with families
Visitors & Public: providing information & directions, welcoming & escorting patients/families/visitors
Retail Services: Gift Shop
Specialty Services: talent sharing (i.e. music, art, knitting, etc.)
Please choose an option:
I Heard About Volunteering at Humber River by:
Other (option not listed):
My Current and Previous Work or Volunteer Experiences:
I am currently:
Current Work or Volunteer Experience:
Current Position or Title:
Dates:
Brief Description of Duties:
Previous Work or Volunteer Experience:
Previous Position or Title:
Dates:
Brief Description of Duties:
My Education:
I am currently a student:
Yes
No
If YES, I am currently a student in:
My grade/level is:
Current School/Institution:
Current Major/Field of Study:
If NO, highest level of education completed:
My Next Steps:
Once you have submitted your application, you will receive an email within 3 - 4 business days with attached documents outlining the required next steps in the application process which includes:
1) Reference Forms: You are required to have 2 professional references complete the form and return them back to you either in a sealed envelope or via email. Professional references may include: employers, managers, teachers, professors, supervisors from previous volunteer experiences, etc. Reference forms may not be completed by family, friends, co-workers, classmates, etc. Applicants contacted for an interview must bring the 2 completed reference forms with them to that meeting.
2) Interview: Only applicants whose interest and availability that match current openings will be contacted for an interview.
3) Volunteer Health Assessment Form: Successful applicants must complete the Volunteer Health Assessment Form prior to starting their volunteer role. The health assessment form must be completed by your family physician or at a walk-in clinic and may take a few weeks to complete. Requirements for health screening include: 2 Step TB test; up-to-date immunization records for measles, mumps, rubella, chicken pox (if immunization records are not available , blood work may be required) and Dtap vaccination. Please note that physicians may charge a fee to complete parts of the health assessment; any costs associated with the health assessment are the responsibility of the volunteer. Completion of the health assessment does not guarantee a volunteer placement.
I Agree to the Following:
By submitting an application for volunteer service I acknowledge, understand and agree to the following:
1) I have provided true and accurate information on my application and I understand that the information I have provided will be kept confidential
2) I give permission for Humber River Hospital to contact my references
3) I understand that by submitting my application it does not guarantee a volunteer placement
4) I understand that if I am accepted into the Volunteer Program that I will comply with the following: uphold the hospital's core values, uphold confidentiality and health screening requirements (any costs associated with the completion of health screening is my responsibility), have regular attendance, and commit to enhancing the experiences of patients, families and staff
Acknowledgement of the Application Process
The Volunteer Services Department at Humber River is committed to providing meaningful and rewarding opportunities for our volunteers. Our volunteers help to make a difference in the lives of our patients, their families and our staff each and every day. Due to the high volume of applications received and the fluctuations of openings, we cannot guarantee that every appilcant will receive a volunteer placement. Only applicants whose interest and availability match current openings will be contacted for an interview.
By typing my name below I confirm that I have read and understood the above. All information provided is true and accurate.
Parental consent is required for applicants under 18 years of age.
By typing my name below, I am indicating consent to my son/daughter participating in Humber River Hospital's Volunteer Program.
Thank you for your interest in volunteering at Humber River Hospital!