UW Health Volunteer Application

New User Details

User ID

User ID (verify)

Password

Password (verify)

UW Health Volunteer Application

Personal Information

First Name

Middle Name

Last Name

DOB (MM/DD/YYYY)

*Volunteers will wear a polo shirt while volunteering. Please choose the size of the polo shirt that you would like:

X Small

Pronouns are personal and a way for us to show respect and create inclusion. What pronouns would you like the volunteer team use during the application process?

She/her/hers

Current Address

Address Line 2

PO Box

City

County

State

Zip Code

Primary Phone

Secondary Phone

E-mail

Current Status and Experience

*Are you a college student?

If you are a college student, list all semesters available for a minimum 6 month volunteer commitment

*Are you a past UW Health Volunteer?

*Are you a current UW Health employee?

Please explain any past volunteer experience. Example: clubs, church, school, other healthcare organizations, ect.

Volunteer Location Interests

Location of Volunteer Interest (select all interests)

Please Indicate Any Language(s) Known

Emergency Contact

Name

Relationship

Phone