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Volunteer Application

UF Health Leesburg Hospital exterior
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Hospital or Location Preference 
I am volunteering as

For Spanish Plaines

Applicant birthdate 

You must be 18 or over. We are not accepting teen volunteer applications at this time.

Name
Current Address
Resident Status - I live in Florida...

If you are not a full-time resident, please let us know how often you reside in Florida

Phone numbers
Are you a current or past employee of UF Health?
Employment info

Please provide some information about your previous employment

From
To
Have you filed a job application with UF Health in the last 12 months?
Volunteer Experience/Community Affiliations
Do you have previous volunteer experience?
Community Affiliations?
Skills

Please check any particular skill or experience you feel would be beneficial as a volunteer

Please list any additional experience such as equipment or machines you operate, computer/technology skills, languages (other than English), recreational activities and/or hobbies you feel might be beneficial

Assignment Opportunities
Please check your preference(s) below. Areas marked with an * require primarily walking/standing, lifting, pushing, pulling
Date you can start
Availability

Must commit to a certain number of hours per week

Tme
Day(s)
Emergency Contact
Background Information
Arrest(s) and/or convictions will not necessarily or automatically disqualify an application from service but will be considered part of the overall evaluation of your qualification and suitability for the assignment sought. The Company will evaluate the nature and gravity of he offense(s), the timing of the conviction or completion of the sentence, the nature of the assignment in question and any applicable individualized considerations.
Have you ever been convicted of, had adjudication withheld or plead guilty or no contender (no contest) to a criminal offense, whether misdemeanor or felony?
I certify that the answers given by me for the foregoing questions and statements are true and correct without omissions of any kind whatsoever and hereby grant the hospital permission to verify such answers. I understand that any false or misleading information furnished by me relative to this application shall be considered rejection of my application for further consideration of volunteer services.
If accepted for volunteer services, I agree to comply with the rules and policies of this hospital and those of the Auxiliary.