Volunteer Application
DATE:
Contact Information PLEASE PRINT
Name
Street Address
City ST ZIP Code
Home Phone
Work Phone
E-Mail Address
Availability
During which hours are you available for volunteer assignments?
___ Weekday mornings
___ Weekday afternoons
Interests
Tell us in which areas you are interested in volunteering
___ Accounting
___ Cardio Rehab
___ Customer Service
___ Escort
___ Gift Shop
___ Skilled Nursing
___ Surgery Waiting
___ Other
Special Skills or Quali cations
Summarize special skills and qualifications you have acquired from employment, previous volunteer
work, or through other activities, including hobbies or sports.
S O N O M A
V A L L E Y H O S P I TA L
S O N O M A V A L L E Y H E A L T H C A R E D I S T R I C T
A N A F F I L I A T E O F U C S F H E A L T H
SONOMA VALLEY HOSPITAL
REV: 01/14/2020
Previous Volunteer Experience
Summarize your previous work/volunteer experience.
Person to Notify in Case of Emergency PLEASE PRINT
Name
Street Address
City ST ZIP Code
Home Phone
Work Phone
E-Mail Address
Agreement and Signature
By submitting this application, I affirm that the facts set forth in it are true and complete. I understand
that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations
made by me on this application may result in my immediate dismissal.
Name (printed)
Signature
Date
Our Policy
It is the policy of this organization to provide equal opportunities without regard to race, color, religion,
national origin, gender, sexual preference, age, or disability.
Thank you for completing this application form and for your interest in volunteering with us.
S O N O M A
V A L L E Y H O S P I TA L
S O N O M A V A LLE Y H E A L T H C A R E DISTR I C T
A N A FFILI A TE O F UC S F HE A L T H
REV: 01/14/2020
General Volunteer Questionnaire
DATE:
PLEASE PRINT
Name
Why do you want to volunteer at Sonoma Valley Hospital?
What skills, education or experience do you have that you feel would qualify you
for this position?
What volunteer position interests you the most? The least?
Please rate your o ce skills…typing, ling, fax machine, computer, knowledge of
phone etiquette.
What do you feel are your strengths and weaknesses in the workplace?
I ed a volunteer position, when could you start?
S O N O M A
V A L L E Y H O S P I TA L
S O N O M A V A L L E Y H E A L T H C A R E DIST R I C T
A N A FFIL I A T E O F U C S F H E A L T H
REV: 01/14/2020
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