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Application for Volunteer Services

It is the policy of Medical City Lewisville to provide equal opportunities without regard to race, color, religion, sex, national origin, or disability.

Education and Employment

Highest Level of Education

Other Skills


Please list two personal or professional references (other than relatives)

About Volunteering

Which days are you available to work?

In making application for a volunteer position, I understand that an investigative report may be made by a consumer reporting agency to verify my background information. I understand the Medical City Lewisville reserves the right to require its volunteers to submit to a Health Screen which includes a urine drug screen, a tuberculin test, and request for immunization records. I understand and agree that if I am offered a volunteer position by Medical City Lewisville, my service will be for no definite term and that either I or Medical City Lewisville will have the right to terminate the relationship at any time, with or without cause, and with or without notice.

By signing below, I attest that I have read and agree to the attached position description and physical demands. I also attest that all the information provided in this application is true and correct.


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