Please fill out this form if you want to volunteer with us.

Volunteer Application

Contact Information
Family/last name
Middle name
First name
Home address
Apt.
City
State
Zip/postal
Home phone
Cell phone
E-mail
DOB
Gender
Volunteer source
Professional and/or other Volunteer Experience, Other Education, Training or Certifications
Hobbies/Skills (Check all that apply)
Primary Language?
Additional languages?
When are the most likely times you are available to volunteer?
AM
PM
Evening
Monday
Tuesday
AM
PM
Evening
Wednesday
AM
PM
Evening
Thursday
AM
PM
Evening
Friday
AM
PM
Evening
Saturday
AM
PM
Evening
Sunday
AM
PM
Evening
Are you required to serve volunteer hours? If so, please enter the number of hours and reason for the requirement>
Mandated hours
Mandated Hours Reason
Volunteer Area(s) of Possible Interest (please check as applicable)
Concierge Services
Emergency Department
Gift Shop
Healthworks
Cancer Center
Patient Visitation/Hospitality
Clinical Musician
VolunTeen
Project Work
Office Work/Clerical/Filing
Fundraising Event Planning
The Birth Place
Mail Delivery
Reference (Please Provide two non-family Members)
Name
Home Address
Phone
Email
Relationship (i.e. employer, co-worker, guidance counselor, etc...)
Name
Home Address
Phone
Email
Relationship (i.e. employer, co-worker, guidance counselor, etc...)
If you are a student what is the name of the school you are attending?
Volunteer Pledge
Believing that Guthrie Corning Hospital has a real need of my service as a volunteer worker.
I will
be punctual and conscientious in the fulfillment of my duties and accept supervision graciously.
I will
conduct myself with dignity, courtesy, and consideration.
I will
consider as confidential all information which I may hear directly or indirectly concerning a patient, doctor or any member of personnel and will not seek information in regard to a patient.
I will
take any problems, criticisms, or suggestions to the Director of Volunteer and Auxiliary Services.
I will
endeavor to make my work of the highest quality.
I will
uphold the traditions and standards of this organization and will interpret them to the community at large.
I agree to the Volunteer Pledge