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Newborns
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Oaklawn Coronavirus Hotline (269) 789-7614
Oaklawn Hospital
Oaklawn Hospital
Honor an Employee
Careers
Patient Portal
News & Blog
Donate
Newborns
Call 269.781.4271
Services
Tools & Resources
Patient Portals
Pay Your Bill
Price Transparency
About Your Bill – Plain Language Summary
Collection Policy
Health Information Management / Medical Records
Financial Assistance Program (FAP)
FAP Application
About Us
Introduction to Oaklawn
Mission, Vision & Values
Board of Directors
Leadership Team
Contact
Ask Us A Question
eNewsletter Signup
Volunteer
Sponsorship Requests
Find a Provider
Find a Location
Oaklawn Hospital
Services
Tools & Resources
Patient Portals
Pay Your Bill
Price Transparency
About Your Bill – Plain Language Summary
Collection Policy
Health Information Management / Medical Records
Financial Assistance Program (FAP)
FAP Application
About Us
Introduction to Oaklawn
Mission, Vision & Values
Board of Directors
Leadership Team
Contact
Ask Us A Question
eNewsletter Signup
Volunteer
Sponsorship Requests
Find a Provider
Find a Location
Volunteer at Oaklawn
Application for Volunteer Services
Check one
*
Mr.
Mrs.
Miss
Ms.
Name
*
First
Middle
Last
Birth Date
*
Date Format: MM slash DD slash YYYY
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
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Congo, Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
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Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
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Ethiopia
Falkland Islands
Faroe Islands
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Finland
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French Polynesia
French Southern Territories
Gabon
Gambia
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Germany
Ghana
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Greece
Greenland
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Guadeloupe
Guam
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Guinea
Guinea-Bissau
Guyana
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Heard and McDonald Islands
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Hong Kong
Hungary
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India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
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Liechtenstein
Lithuania
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Madagascar
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Mali
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Micronesia
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Panama
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Saint Barthélemy
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Saint Kitts and Nevis
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Samoa
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Senegal
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Seychelles
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Singapore
Sint Maarten
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Slovenia
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Spain
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Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
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US Minor Outlying Islands
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Virgin Islands, U.S.
Wallis and Futuna
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Country
Phone Number
*
Email
*
Education (Highest Level Completed)
*
If employed, Name of Company and their Phone Number
*
Position at work?
*
May we contact you at work?
*
Are you retired?
*
Yes
No
Previous Work Experiences (if retired)
Previous and/or Current Volunteer Experiences
*
Have you been terminated from volunteering?
*
Yes
No
If Yes, please explain
Skills, Special Interests
*
Community Affiliations (Social, Service)
*
How did you become interested in our volunteer program?
*
General Condition of Health?
*
Do you have any physical limitation that would affect your volunteering? If yes, please explain.
*
Emergency Contact Name
*
Emergency Contact Relationship
*
Emergency Contact Phone Number
*
Please provide a reference (Name, Relationship, Address, Phone Number)
*
Please provide a 2nd reference (Name, Relationship, Address, Phone Number)
*
May we have permission to check information and references?
*
Yes
No
Availability for Volunteer Assignment
Monday Morning
Monday Afternoon
Monday Evening
Tuesday Morning
Tuesday Afternoon
Tuesday Evening
Wednesday Morning
Wednesday Afternoon
Wednesday Evening
Thursday Morning
Thursday Afternoon
Thursday Evening
Friday Morning
Friday Afternoon
Friday Evening
Saturday Morning
Saturday Afternoon
Saturday Evening
Length of Commitment (1 semester, 6 months, 1 year, indefinite, other)
*
Do you have a specific assignment in mind? (refer to list at the bottom of this page)
*
Please give a sentence or two explaining your reasons for seeking vounteer service.
*
Do you speak a language fluently other than English?
*
Yes
No
If yes, please list the languages
Please type your name to confirm your understanding and agreement to the following:
I have completed the above information to the best of my ability and understand that any falsification of the information provided above may prohibit my activities as a volunteer. I agree to inform Oaklawn Hospital Personnel office of any changes. If I am selected as an Oaklawn Hospital Auxiliary volunteer, I agree to abide by all the hospital rules, regulations and expectations. I understand that either party may cancel this relationship at any time.
Name
*
First
Last
Qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status.