Adult Volunteer Application

Personal Information

Name*

Other names used

Street Address

Apt.

City

State

Zip

Home Phone

Cell Phone

E-mail Address

Date of Birth (Applicants must be 18 years or older)

Emergency Contact Information

Emergency Contact Name

Emergency Contact Phone Number

Emergency Contact Address

Your relationship to the contact

Personal References (not related to you)

Reference #1 Name

Reference #1 Phone Number

Reference #2 Name

Reference #2 Phone Number

Personal Skills

Work Experience

If you're currently working please write the name of your employer and how many hours you work per week

Availability

Please list previous community involvement (at hospitals, schools, agencies, boards/committees, caregiver roles)

Why would you like to volunteer with us?

Were you referred/recruited by anyone?

Your preferred style of volunteer service

Patient Contact Reception Clerical Computer Craft-Related Gift Shop Clerk Other

Thank you for your interest in the Volunteer Program at Medical City McKinney. Before you select Submit, please right click and select Print so you will have a copy of the application. Then call (972) 547-8010 (the Front Desk) to schedule a personal interview on a Tuesday or Thursday, at 9:30 a.m. or 10:30 a.m.