top of page
ABOUT US
Staff
Board of Directors
2021 Annual Report
NEWS
SERVICES
Clinic FAQ
Appointments
Clinic Hours
Specialty Care
Laboratory Services
VOLUNTEER
How to Volunteer
Volunteer FAQ
Volunteer Positions
SUPPORT
Donate
FIELD DAY
CONTACT
More
Use tab to navigate through the menu items.
Volunteer Application (Non-Healthcare)
Thank you for your interest in volunteering for The Clinic! We ask that you complete this application as a first step to becoming a volunteer.
How did you hear about us?
Have you worked or volunteered at The Clinic before?
Yes
No
If so, when?
Are you or family member currently served by The Clinic?
Yes
No
Name
Street Address
City
State
Zip Code
Email
Phone
Please tell us why you want to volunteer and what you hope to gain from the experience.
Please note any physical limitations.
Other language(s)
Proficiency
Native speaker
Fluent
Conversational
What volunteer opportunities interest you?
Front desk/reception
Data entry
Marketing
Translation
Scheduling/records
Business or volunteer office
Facilities/Landscaping
Please check the day(s) you are available:
Monday
Tuesday
Wednesday
Thursday
Friday
Please check the time(s) you ae available:
8:45-noon
12:45-4:00
4:00-6:00 (when available)
What is your time commitment?
Six months
One year
School year
Summer
How often would you like to volunteer?
1 time per week
Several times per week
Every other week
Education/Degree
Year of graduation
Are you currently a student?
Yes
No
If yes, degree sought and major:
Anticipated graduation date
Last PPD test
COVID vaccination
Have you ever been convicted of a crime?
Yes
No
If yes, please explain.
The information contained in this application is correct to the best of my knowledge.
Submit
bottom of page
