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Adult Volunteer Application Form

Thank you for your interest in volunteering at Chester County Hospital!

If you wish to be considered for a volunteer position, please complete and submit the online form at the bottom of this page. You will be contacted shortly by our Volunteer Office.

Health Compliance Note: It is mandatory to have a Tuberculosis test prior to entering the hospital as a volunteer. It is also mandatory for all volunteers to receive an annual flu shot vaccination during each flu season (October 1 through December 1). As of 9/1/2021, all volunteers must provide a copy of their COVID-19 vaccination record and must  be fully vaccinated in order to volunteer with Penn Medicine Chester County Hospital.

 


Chester County Hospital Adult Volunteer Application Form


Please complete the form below and hit SUBMIT when you are done. All fields marked with an asterisk (*) are required.



CONTACT INFORMATION
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Preferred Method of Contact
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PERSONAL INFORMATION
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Have You Previous Been Employed By or Volunteered at Any Other Penn Medicine Entities?
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Do You Have Relatives Who Work For or Volunteer for Penn Medicine or CCH?
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Were You Referred to Volunteer at CCH?
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Have You Volunteered in a Healthcare Setting Before?
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Is English Your First Language?
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Are You Bilingual
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Are You a Year-Round Resident of the Chester County Region?
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Have You Ever Been Convicted of a Felony or Misdemeanor
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Can You Commit to a Minimum of 60 Hours of Service?
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PREVIOUS VOLUNTEER EXPERIENCE
EDUCATION
Highest Level of Graduation
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Are You Volunteering to Complete a Class?
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EMPLOYMENT HISTORY
Current Employment Status
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EMERGENCY CONTACT INFORMATION
MEDICAL INFORMATION
SKILLS AND EXPERIENCES
Administrative/Office (Check All That Apply)
Medical (Check All That Apply)
Computer (Check All That Apply)
Miscellaneous (Check All That Apply)
Do You Hold Any Certification or Licensure?
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INTERESTS
Volunteer Areas
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Physical Abilities
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AVAILABILITY
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Preferred Days to Volunteer
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Preferred Shift
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ADDITIONAL INFORMATION
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