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Dear Potential Volunteer:

Thank you for your interest in Shriners Hospitals for Children Northern California. We are pleased that you would like to volunteer your services to assist our patients and support our staff. Enclosed is a volunteer application. Please take the time to complete the form and provide the necessary references. We would appreciate a copy of your current resume, if available.

Please note that volunteer candidates must be at least 18 years old and be able to make an ongoing commitment to the hospital. A list of possible volunteer opportunities is attached to the application. Please check off those that interest you.

Our application process has a variety of steps, which we would like to explain. If the applicant may fill a hospital need, an interview is scheduled or the potential volunteer is invited to an informational meeting. Next, if the staff determines that the candidate is suitable to serve within a pediatric hospital environment, an introduction to a potential supervisor is scheduled.

Applicants who are successful will then have their applications, and interview comments carefully reviewed by departmental supervisors. The departmental supervisors may interview those applicants who most closely match their current needs and may test applicants for proficiency in desired skills.

An applicant who is selected by a departmental supervisor will be contacted to participate in an orientation to learn about hospital policies and procedures and the special privileges accorded volunteers. A TB test and health survey are required at that time. Volunteers must indicate immunity to measles, chicken pox and rubella in addition to a Hepatitis B series. All applicants are required to take a drug test and agree to a background check to complete the application process. We hope that this will explain our selection process for potential volunteers and trust that you will understand the necessity of careful screening. We thank you again for your interest. Please contact the Volunteer Services Department at (916) 453-2087 if you have any questions.

Sincerely,
Lillian Nelson
Volunteer Services Department

Cathy Bones
Manager, Volunteer Services/Pet Therapy Coordinator
Dear Volunteer Candidate:
Shriners Hospitals for Children Northern California requires all applicants offered positions of employment or volunteer service to be processed through our Employee Health Department.

Employee applicants/volunteers will be required to successfully complete a pre-assignment drug test, a criminal background investigation and health screening requirements appropriate to your job or volunteer assignment.

You will be asked to supply the following information, which will be retained in a confidential health file in the Employee Health Office. Information from your file may not be released without your written permission however it may be reviewed, on an as needed basis, by regulatory officials or for occupational injury or emergency medical providers for hospital related exposures or injuries. Please provide copies of your immunization records upon offer of an employment position or with your application if you are a volunteer candidate.

1.) a copy of your most recent tuberculosis (PPD) skin tests or written chest x-ray results if you had a previous positive test

2.) a copy of your most recent physical- employee applicants only. (if completed within the previous 12months)

3.) a copy of your immunization records or proof of immunity for Rubella (1 vaccination or titer)

4.) a copy of your immunization records or proof of immunity for Rubeola (2 vaccinations or titer if born after 1957; if born prior to 1957 1 booster vaccination or titer).

5.) Varicella (History or 2 vaccinations)

6.) For those at risk to exposure to blood borne pathogens, a copy of your Hepatitis B vaccination records. Volunteer candidates will start pre-assignment screening paperwork through the Volunteer Services Office, which will then be forwarded to Employee Health for processing and contact with candidate. Please contact Employee Health at (916) 453-2026 for questions or assistance. Processing for for volunteers usually takes 5-10 working days.

Volunteer Information Form (Print and send the following application to Shriners Hospital)


Lillian Nelson
Volunteer Services Coordinator
Shriners Hospital for Children - N. CA.
2425 Stockton Blvd
Sacramento CA 95817

(916) 453-2000



Name: ______________________________________________________________

Address: ______________________________________________________________

City/State/Zip Code: ______________________________________________________________

Home Phone: _______________________________
Work Phone: ____________________________________
Present Employer: ____________________________
Position: _______________________________________
Employment &Professional Experience:

______________________________________________________________

______________________________________________________________

Educational Background:

______________________________________________________________

______________________________________________________________

Volunteer Activities:

______________________________________________________________

______________________________________________________________

Please list language(s) spoken fluently other than English:

______________________________________________________________

Please indicate computer skills:

______________________________________________________________

Interests, skills, hobbies:

______________________________________________________________

______________________________________________________________

______________________________________________________________


Date of Birth:(month/day/year) _______________ Email:

_____________________________________________

What makes you interested in a position at Shriners Hospital?

______________________________________________________________

______________________________________________________________

What days and times are you available?

______________________________________________________________

______________________________________________________________

Have you ever been convicted of a felony?

_______________________________________________________

If "yes" give date, place and disposition:

______________________________________________________________

______________________________________________________________

In event of emergency, call:

______________________________________________________________

Telephone number:

______________________________________________________________

References:
Please list the names of two individuals we can contact as a reference. Do not list relatives.
Name: _______________________________ Telephone:_______________
Name: _______________________________ Telephone:_______________

I authorize investigation of all statements contained in this application and any supporting documents and I understand that a backgroung check may be conducted. I authorize Shriners Hospitals for Children to secure information about my education or experience from employers, educational institutions, government agencies, or other references I have provided and I release all parties from any liability arising from such investigation.

Signature: ____________________________ Date: ___________________



Volunteer Opportunities - Shriners Hospitals For Children, Sacramento
Please check all areas of interest to you:
PATIENT CONTACT POSITIONS

_____ Artist in Residence/Entertainer: Visual, Crafts, Performace

_____ Genetic Counselor

_____ Interpreter: Spanish, Russian, Hmong, Vietnamese

_____ Library Aides

_____ Nursing/Patient Escort

_____ Occupational Therapy (requires interest in pursuing graduate studies in this field)

_____ Out-patient Clinic

_____ Pet Therapy (Animal Assited Activities/Animal Assisted Therapy)

_____ Physical Therapy (requires interest in in pursuing graduate studies in this field)

_____ Teacher's Aides

_____ Therapeutic Recreation (Child Life): sports & leisure activities, board games, movies, arts and crafts, reading, cooking

OTHER

_____ Computer/Data Entry

_____ Environmental Services/Housekeeping

_____ General Office Assitance

_____ Hospitality Desk (4th Floor)

_____ Materials Management/Supply/Loading Dock

_____ Nutritional Services: Kitchen, Clinical Nutrition

_____ Public Relations/Special Events/PROS

_____ Research Laboratory