Volunteer Application Of Royal Inland Hospital
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1
2VOLUNTEER APPLICATION
Royal Inland Hospital
Personal Information
Mr
Ms
Mrs
Miss
Other _________ Preferred First Name:
__________________________
Last Name:
First Name:
_______________________________________________
___________________________________
Address:
________________________________________________________________________________________
City:
Postal Code:
_________________________________________________
|___|___|___|
|___|___|___|
Telephone:
Home:
Business: (____)_______________________________________________
(____) _________________
Cell:
E-Mail: _______________________________________________________
(____) _________________
Note: Your personal contact information will be used by Interior Health for the purposes of scheduling your shifts and other administrative
functions and communications relating to Volunteer Services.
Interests
Why are you interested in volunteering for RIH? _____________________________________________________
__________________________________________________________________________________________________
What type of volunteer programs interest you?
____________________________________________________
__________________________________________________________________________________________________
Please indicate blocks of specific times that you are available for volunteer work in the spaces provided:
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
AM
PM
EVE
Would the times be regular, or would they need to change frequently?
Regular
Change
If your hours would change frequently, please explain:
_____________________________________________
Abilities/Skills
List any hobbies/skills/interests: ___________________________________________________________________
__________________________________________________________________________________________________
Do you speak and/or write languages other than English:
No
Yes
If YES, please specify: _____________________________________________________________________________
Office Use Only:
Rec’d Date:
On Hold Date:
Comments / Notes:
nd
Return completed applications to: Royal Inland Hospital – place in drop box on the 2
floor next to the
Switchboard/Cashier OR mail to Attn: Volunteer Services - 311 Columbia Street, Kamloops, BC, V2C 2T1
Phone: 250-314-2313 Fax: 250-314-2795
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