Volunteer Form
Thank you for your interest in our Volunteer Program. Annually we average 650 volunteers contributing 82,000 hours in 80 different areas of the hospital. But we still have many areas in need of volunteer assistance. We do hope you will decide to join our hospital family.

Our volunteers are screened very carefully and are asked for a specific commitment (see Volunteer Agreement). Please review the prerequisites and Volunteer Agreement before completing the Volunteer Application to make sure you can meet the criteria for becoming a Holy Cross Hospital Volunteer. If you have any questions, please feel free to contact us at 301.754.7305.

*Denotes required fields.

Personal Information
*Last Name:
*First Name:
 MI:
Title:
*Street:
 		*City:
 *State:
 *ZIP:
*Home Phone:
Work Phone:
School Phone:
*Age:
*Date of Birth:
Social Security Number:
*Preferred Type(s) of Volunteer Work:
Public Office Undecided
Available to Volunteer Information
*Number of Days Per Week Available to Volunteer:

*Hours Per Day Available to Volunteer:
*Date You Can Begin:
*Latest Date You Would Stop:
*Please indicate the times that you are available to volunteer on the appropriate day(s) of the week:





*How Long Do You Plan to Volunteer?

Paid/Volunteer Experience
Current Status:
Days/Hours of Employment:
Discuss your current of most recent position first.
Job Title:
Company Name:
Dates From:
Dates To:
Supervisor:
City:
State:
 Phone:
Duties:
Reason for Leaving:
 
Job Title:
Company Name:
Dates From:
Dates To:
Supervisor:
City:
State:
 Phone:
Duties:
Reason for Leaving:
List any skills and/or hobbies you participate in or are interested in:
*Why Do You Want to Volunteer?

*Primary Language Spoken:

Education Training
Career Goal:
High School Name:
Dates From:
Dates To:
Graduated?
College Name:
Dates From:
Dates To:
Graduated?
Other Training:
*Have you ever volunteered at HCH before?

Year(s):
Name (if different that above):
Area(s):
*How did you become interested in/find out about volunteering at HCH?

*Will you park a vehicle at the hospital?
Organizations (clubs, churches, etc) in which you are a member:
In Case of an Emergency, Contact:
*Name:
*Relation:
*Address:
*Home Phone:
*Work Phone:
Health Survey
Date of last TB skin test:
Reaction:
For the following, check those applicable to you and elaborate, if you want:
References
List two (2) people in the Washington, D.C. Metro Area who have known you longer than one year – prefer supervisor or co-workers. Do not include relatives.
Name:
Capacity known:
Daytime Phone:
Name:
Capacity known:
Daytime Phone:

Volunteer Agreement
Click here to download the volunteer agreement. You must print, fill out and sign this agreement, and bring it with you to your interview.

Click the submit button below to send you online volunteer application to Holy Cross Hospital.