Volunteer – Wilmington Community Clinic

Wilmington Community Clinic

Volunteer Application Form

Volunteering has many benefits: You can look at the good work you do for the community. You can look at the difference you make to others. You can look at the difference you make to yourself. Whether you wish to learn a new skill, have a drive to help others or just enjoy the feeling of “doing good”, we welcome your help.

1009 N. Avalon Boulevard, Wilmington, CA 90744
Phone: (310) 549-5760 | Fax: (310) 549-2277 | Email: info@wilmingtoncc.org

Full Name

Address

City

State

ZIP Code

Home Phone

Cell Phone

Email Address

Emergency Contact Name

Emergency Phone

Emergency Cell

How did you hear about Wilmington Community Clinic?

If you have a specific volunteer position in mind, please describe:

What is your reason for volunteering and what do you hope to gain from your experience?

How soon are you available to start volunteering?

What is your availability in terms of days and hours?

Please list any licenses or certificates (e.g. CPR, MD, RN, CNA, etc.) relevant to your desired volunteer position:

Please describe any skills, experience, or education relevant to your desired volunteer position (e.g. diabetes education, mental health worker, receptionist, clerical, etc.):

Foreign language abilities:

Additional information or comments:

Volunteer Expectations — I agree to the following: • This is a volunteer position with no compensation or path to paid employment. • I will complete all volunteer requirements and paperwork. • I will provide proof of physical exam and negative TB test each year. • I will provide proof of applicable licenses. • I will treat all patients, volunteers, and staff with dignity and respect. • I will observe patient confidentiality per HIPAA guidelines. • I will attend required training sessions and meetings. • I will respect the policies, rules, and regulations of WCC. • I understand my application is subject to a complete background review. • I understand that failure to follow these expectations may result in dismissal.

Printed Name

Date

FAQs

Questions?
Glad you asked.

Discover quick answers to common questions about volunteering and our charity organization.

1. What types of volunteer roles are available?

Volunteer Reader
Administrative help
Maintenance
Public Relations
Fundraising
Reception
Calling Donors
Community Outreach
Photography

2. What we are currently looking for

Volunteer Reader
Administrative help
Maintenance
Public Relations
Fundraising
Reception
Calling Donors
Community Outreach
Photography

Wilmington Community Clinic

Volunteer Application Form

FAQs

Questions?Glad you asked.

Questions?
Glad you asked.