On-line Volunteer Form


        






Address & Contact Information





       



     

 

Emergency Contact

         



                                       

 

Special Needs or Limitations






Historical Information







 

Skills, Interests and Experience

















 

Students


                                 

 

Volunteer Interests


Clerical/Administrative
Clinical Support
Gift Shop/Cashiering
Harrison Foundation Events
Patient Escort/Hospitality
Projects
Other

If other, please tell us about your particular area of interest.


Belfair
Bremerton
Port Orchard
Poulsbo
Silverdale

Availability (in most cases we ask for a six month commitment of at least one shift per week)


The information provided on this application is true and complete to the best of my knowledge. I understand that my placement as an in-hospital volunteer is contingent upon acceptance by the Volunteer Resources Department based upon a personal interview and available position, satisfactory references and background check(s) for criminal history based upon the following as appropriate: a satisfactory National and/or WA State Patrol background check and an OIG Excluded Provider List screening all in accordance with all state and federal laws, a completed Child and Adult Abuse Disclosure Statement, and attendance at a Volunteer Orientation including completion of compliance forms and trainings. I understand I will not be paid for any volunteer services provided.