Hello! Thank you for applying for San Mateo Medical Center's Long-term volunteer program. Applying for the Long-term volunteer program does not guarantee your placement within the volunteer program. The Volunteer Coordinator will contact you within 7-10 business days of submission. Answer questions 18-21 with a minimum one-paragraph response. We are looking for volunteers Monday-Friday 7:00-3:30 p.m

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* 1. Name

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* 2. How old are you? Volunteers must be at least 15 years old to volunteer at San Mateo Medical Center.

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* 3. Birthdate

Date

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* 4. Can you commit to volunteer a minimum of four hours a week for the next year, 2025-2026?

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* 5. I understand that volunteers must complete 50 hours as a greeter before rotating to other departments.

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* 6. Phone number

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* 7. Email address

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* 8. Address, City, State, Zipcode

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* 9. Emergency Contact

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* 10. Do you speak a language other than English fluently? What is the language, and would you be willing to speak that language to help patients?

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* 11. Have you volunteered in San Mateo Medical Center before? If yes in what year?

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* 12. What is the highest level of education you have completed?

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* 13. What are your hobbies, skills and special interests?

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* 14. Volunteer or work experience that may be helpful in placing you.

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* 15. Please explain briefly your reasons for volunteering

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* 16. Please indicate specific position(s) or area(s) of interest:

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* 17. Please give any other information you feel is pertinent to your application

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* 18. Tell me about a time you made a error. What was the error? How did you fix it? What did you learn from it? (One Paragraph response minimum)

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* 19. How would you handle a situation where you witnessed another volunteer or staff member acting inappropriately?(One Paragraph response minimum)

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* 20. Can you tell us about a time you had to demonstrate empathy or compassion for someone?(One Paragraph response minimum)

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* 21. What is the most interesting place you’ve ever traveled to, and what did you learn from the experience?

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* 22. Personal and professional references (Please exclude family): List two references.

Examples: Teachers, Coaches, Tutors and employers

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* 23. Please be aware that a criminal record does not automatically disqualify you from volunteer work at SMMC. Have you ever been convicted of a crime? If yes, please describe the nature below.

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* 24. Have you ever been arrested for an offense for which you are currently out on bail or your own recognizance, pending trial? If yes, please describe the nature below.

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* 25. PLEASE READ THE FOLLOWING AND SIGN TO ACKNOWLEDGE YOUR AGREEMENT:

I hereby make application to the volunteer organization of San Mateo Medical Center (SMMC). I fully understand that any significant misstatement in or omission from this application will constitute cause for denial or revocation of my volunteer status. I hereby affirm that the information furnished by me is true and complete to the best of my knowledge and is furnished in good faith. I present this application in the expectation that the confidentiality and privacy of this information will be preserved.
Because I am donating my time, I understand that I am not an employee of SMMC and that I will not be paid for my work. I also understand that this organization is not obligated to provide a placement, nor am I obligated to accept the position offered.

I agree:
1. To perform my duties to the best of my ability.
2. To adhere to all medical center rules and procedures, including the policy of non-discrimination and harassment.
3. I will consider as confidential all information, which I may hear directly or indirectly concerning a patient, doctor, or any member of the medical center staff.
4. That all volunteer assignments can be terminated at any time, by either party, with or without notice and with or without cause. No volunteer assignment is guaranteed for any specific period of time.
5. To meet time and duty commitments, or to provide adequate notice so that alternate arrangements can be made.
6. That SMMC may check references, and/or do a background check which may include a fingerprint check and may use such information as may be obtained in making a decision regarding my placement.

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