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Volunteer Application

In our ongoing effort to recognize our volunteer’s service, compassion and dependability, we ask that you fill out this form to allow us to get to know you and your needs better.

Personal Information
Emergency Contact
Education

Please provide information on the highest level of education completed.

If student, current name of school and area of study (college/graduate school), or if employed, your current employer and occupation, or if retired, your former employer and occupation. Thank you!
Areas of Preference
(please indicate what cities and states)
Previous Volunteer Experience

If yes, please complete the following:

History

If yes, Inova Blood Donor Services does not accept anyone whose offense(s) include, but are not limited to, theft, assault or drugs. Also, Inova Blood Donor Services does not accept anyone for court-ordered community service.

Inova Standards of Behavior

Professionalism – Confidentiality & Privacy – Sense of Ownership – Accountability – Commitment to Each Other – Safety Communication – Stewardship – Caring Relationships

Our Standards of Behavior are the foundation of our service excellence culture. It is expected that all volunteers will live these standards and by following them we will bring our mission, beliefs and commitments to life and accelerate our vision to be the best healthcare system in the world.

Some volunteer assignments require extensive walking or standing, or carrying moderately heavy items, adequate hearing for handling phone requests and the like. Some duties may also call for polite and calm responses under stressful circumstances. If you feel you have any condition that might affect your performance of required duties or if you would prefer for your own safety to avoid certain tasks, please indicate the type of work you feel is unsuitable for you.

Authorization Agreement

All information provided on this application is accurate and correct to the best of my knowledge. I understand that any misrepresentation, misstatement or omission regarding this application will result in denial or termination of a volunteer position.

I further understand that the hospital is authorized to verify all information provided and that if a volunteer position is offered, I may be asked to furnish documents supporting statements herein.

I understand that this application is intended to create a promise of, or volunteer agreement between Inova Blood Donor Services and myself for either volunteering or the providing of any benefit. If a volunteer relationship is established, I understand that my status as a volunteer will be at will and that I or Inova Blood Donor Services have the right to terminate my status as a volunteer at any time, for any reason.

If Under 19, Signature of Parent/Guardian
reCAPTCHA is required.