Volunteer Application

Thank you for your interest in volunteering!  You may either complete the application below and submit it online, or download the application in Word or PDF format to print and mail.

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We are experiencing some "technical difficulties" with the Submit button on this page.
We are working on resolving this issue as quickly as possible. 
If you would like to submit an application, please print and mail a copy of this page. 
We apologize for the inconvenience, and thank you for your patience.

PDF - Click here to download application in PDF format.
Word - Click here to download application in Word format.

Name:
Address:
City/State/Zip:
Phone:
Email Address:
Birthday:
School (if under age 18)
How did you hear about Kate's Kart:
Do you have any previous volunteer experience? If so, please tell us about it:
Why do you want to volunteer for Kate's Kart:
Do you have any experience in a hospital setting?  Do you have any apprehensions about being in a hospital:
At which hospital(s) would you like to volunteer (please check all that apply): Dupont Hospital (Mondays, Thursdays)

Lutheran Hospital (Mondays, Wednesdays, Fridays)

Parkview Main (Tuesdays, Thursdays, Saturdays)

Parkview North (Mondays, Thursdays)
What days/times are you available to volunteer:
Please initial that you understand and agree to each statement below:

I agree to attend an initial orientation session required by the hospitals, including paperwork, a background check and TB testing.

I agree to renew my TB test annually and keep my files active and complete at each hospital that I am a volunteer.

I agree to adhere to the dress code (which will be explained by each hospital).

I agree to communicate regularly with my Kate's Kart volunteer scheduler in regards to my personal volunteer schedule.

I agree to fulfill my assigned date(s) and will take it upon myself to find a replacement or let my Kate's Kart volunteer scheduler know (with sufficient notice) if I am unable to fulfill my assignment.

I understand that not showing up for an assigned date without notice may result in my not being scheduled in future months.

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