Requirements: Must be 21 or older, complete background check, TB test, volunteer orientation, flu shot (depended on season)

Prefered Contact *
HomeMobile
Gender *
MaleFemale

Emergency Contact Information

Do you have any physical or medical conditions which will limit your ability to perform volunteer service or will require any special accommodation? *
YesNo

History and Availability

How did you hear about our volunteer program? *
SelfWebsiteEmployeeVolunteerSchoolAdvisorOther

Employment / Experience / Education

Work Status *
StudentHomemakerRetiredEmployedSeeking Employment
Level of education completed *
HS DiplomaGEDUndergraduateMastersPhDSome College

Volunteer Availablity

Please place a "Y" in available work areas *

Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Morning
Afternoon
Evenings
Do you prefer *
Patient ContactNo Patient ContactClericalOther
Are you willing to be called with special projects? *
YesNo

Background Check

A background check will be conducted on all adult volunteer applicants. CTC conducts criminal history checks on every volunteer. Please note that conviction of a crime is not an automatic disqualification. Failure to disclose or provision of false information will result in the disqualification and/or termination of the application.

No volunteer at CTC will discriminate against an applicant for volunteering or a fellow volunteer because of race, creed, color, religion, sex, national origin, ancestry, age or any physical or mental disability."

Is your volunteer service intended to satisfy court-ordered community service? *
YesNo

**Please attach a copy of your driver’s license and a copy of your food handler’s card, if applicable.** Professional Volunteers please attach applicable licensure or certifications.

Volunteer Commitment to Confidentiality and Service

Should I be accepted as a CTC Volunteer, I agree to:

  • Maintain the confidentiality of all information which I may obtain directly or indirectly concerning patients, physicians, volunteers or staff.
  • Not seek confidential information in regard to any patient.
  • Uphold the Mission, Vision, Values, and Code of Conduct of CTC.
  • Make every effort to fulfill my volunteer commitment.

I certify the statements made in this application are true and correct and given voluntarily. I understand that my time and services are donated to CTC without contemplation of future employment and also understand that I will not be paid for my services as a volunteer. Prior to the onset of serving as a volunteer, I
understand that I will be required to complete an Orientation, Occupational Health Screening, and additional training that a service assignment may require.

I am aware that the misrepresentation and/or withholding of information may result in the rejection of this application or cause my discharge if discovered after volunteer service commences.