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Volunteer Application

Thank you for your interest in becoming a Thompson Health volunteer!  Please fill in all of the information below - be aware that all fields are required for the form to go through.  For questions or more information, contact the Volunteer Office at (585) 396-6660.

To Become a Volunteer

  1. Submit the online application below (or you can pick one up at the hospital lobby Information Desk)
  2. Call the Volunteer Office at 396-6660, Monday - Friday to verify your application was received and to schedule an appointment for an interview
  3. Make a commitment of at least 3 - 4 hours each week (seasonal volunteers also needed)
  4. Complete the Volunteer Orientation Program
  5. Complete the health assessment steps

Volunteer Application Form

Last Name *
First Name (Legal) *
Address
City
State
Zip
Email *
Phone *
Do you have a legal right to remain and work in the United States?
Have you ever been convicted of a crime?
If yes, please explain
High School Name
High School Degree
Have you ever been employed here before?
Please list your employment or volunteer work during the last 10 years.
Date FromDate ToName of EmployerPosition Held
Select Date Select Date
Select Date Select Date
Select Date Select Date
Select Date Select Date
When are you available? Days/Hours available? (Check any that apply):
 DayTimes Available
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Please check any task in which you have
an interest and/or experience













Are you currently a member of the Thompson Guild?
Please list former supervisors, associates, and/or acquaintances with whom you are familiar and who could be contacted as a reference for you. Do not list relatives.
Name
How Long Known
Phone
Name
How Long Known
Phone
The information provided in this application to volunteer is true, correct and complete. I understand that, if I volunteer, any information found to be false might subject me to dismissal. I authorize the use of any information in this application to verify my statements, and I authorize personal references to answer all questions concerning my ability to perform the volunteer task for which I am applying. If I become a volunteer, I agree to abide by all present and subsequently-issued Health System policies. This agreement does not bind with party for any specific period of time.
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We are an Equal Opportunity Employer and do not discriminate based on race, color, gender, age, disability, religion, marital status, citizenship, national origin, sexual orientation, gender identity, or veteran status.