Boston Medical Center Volunteer Application

* Legal First Name

* Legal Family/last name

Preferred First Name

Preferred Pronouns

* Date of Birth

* Address

Address line 2

* City

* State

* Zip/postal

* Phone (Mobile)

E-mail address

Availability

Please indicate the days and times you are available to volunteer. We ask volunteers to commit to one shift per week for a minimum of 6 months. Most of our available volunteer roles are from 6am-6pm Monday-Friday. Please keep in mind that your start date is when you are expected to begin coming into the hospital weekly to volunteer. This will be approximately 1-2 months after acceptance letters are sent. We require a six-month commitment from all volunteers.

Monday

6am-9am

9am-12pm

12pm-3pm

3pm-6pm

Not available this day

Tuesday

6am-9am

9am-12pm

12pm-3pm

3pm-6pm

Not available this day

Wednesday

6am-9am

9am-12pm

12pm-3pm

3pm-6pm

Not available this day

Thursday

6am-9am

9am-12pm

12pm-3pm

3pm-6pm

Not available this day

Friday

6am-9am

9am-12pm

12pm-3pm

3pm-6pm

Not available this day

* Start Date

* End Date

Education & Employment

Please select your current or highest level of education and current employment status.

Education

Currently Enrolled

Completed or Declared Major

* School

* Please list your current or most recent employer and position title

Please list any previous volunteer experience including length of position, role title, and tasks (if applicable)

Interests, Skills & Language Fluency

Skills

Please list additional languages spoken

Interests in Volunteering

* Please describe why you would like to become a volunteer at Boston Medical Center (250 word minimum)

Emergency Contact

* Contact name

* Relationship

* Address

Address Line 2

* City

* State

* Zip/postal

* Phone (Mobile)

Phone (Home)

Phone (Business)

Internal Information

How did you hear about us?

* Current employee and department

* First and Last Name

* Volunteer Name

Past BMC Affiliate (Volunteer or Employee or observer Etc.)

Open to event-based volunteering

Demographic Information

Optional

Extended gender

If you chose other please specify

What is your race?

Other, please specify

How would you describe your sexual orientation

Have you ever served on active duty in the U.S Armed forces?

Do you have a disability or chronic condition (physical, visual, auditory, cognitive, mental, emotional, or other) that substantially limits one or more of your major life activities, including mobility, communication (seeing, hearing, speaking), and learning?

If you selected prefer to self describe please specify

Criminal Background Check

Boston Medical Center must be able to assure hospital safety for any children or patients in their care. Upon acceptance to the volunteer program, you will be required to complete a CORI Background Check. This information will remain in the strictest confidence and will only be used to determine your suitability for a certain placement. The existence of a criminal conviction history is considered only to the extent that it would impede the performance of a function essential to a particular position.

Agreement

I understand that acceptance of this application is contigent upon the hospital obtaining satisfactory references and a satisfactory Criminal Offender Record Information (CORI) check. I certify that the satements made in this volunteer application are true and correct, and have been given voluntarily. I understand that this information may be disclosed to any party with legal and proper interest, and I release the agency from any liability whatsoever for supplying such information.

I understand that I will not be paid for my services as a volunteer.

[ clear ]

Signature

Thank you for your interest in volunteering at Boston Medical Center! Please complete the below application and click "Submit" when finished.

Availability

Education & Employment

Interests, Skills & Language Fluency

Interests in Volunteering

Emergency Contact

Internal Information

Demographic Information

Criminal Background Check

Agreement