Welcome to The Lee Health Volunteer Site

Lee Health Adult Volunter Application - Ages 18 and Older

If you are able to commit to volunteering one 4-hour shift per week for 4-consecutive months from your first day of work and you are able to complete the necessary Health Requirements listed on the previous page, please apply to volunteer!

HIGHLIGHTED AREAS and THOSE WITH ASTERISK ARE REQUIRED FIELDS

PLEASE SUBMIT ONLY ONE APPLICATION

At which Lee Health location do you prefer to volunteer?

NOTE: Babies and Children are only treated at Golisano Children's Hospital of SWFL

Are you a Seasonal or Year Round Resident?

How did you hear about our Volunteer Program?

Have you ever been a Lee Health Employee or Volunteer?

If seasonal, which months available to volunteer

PERSONAL INFORMATION:

* First Name

Middle Name

* Last Name

* Preferred First Name (for badge)

Maiden Name/other last name known by:

* DOB

Gender

Race/Ethnicity (optional)

* Address (Local)

* City

* State

* Zip/postal

* Phone

* E-mail

Are you a Veteran?

If yes, what branch?

SEASONAL ADDRESS (if applicable):

Address

City

State

Zip/postal

IN CASE OF EMERGENCY, NOTIFY:

* Contact Name

* Relationship

* Phone Number

EDUCATION INFORMATION:

High School Graduate/GED

Are you currently enrolled in school?

College Degree Received

If currently enrolled in school, name of College/University

Year of Graduation

Major(s)

BACKGROUND INFORMATION:

Have you ever been convicted of, had adjudication withheld, or pled guilty or nolo contendre (no contest) to a criminal offense (misdemeanor or felony)? (We do criminal checks. Falsification or failure to disclose this or any other information on this application is grounds for termination. A conviction does not necessarily disqualify you from volunteer services).

Please select yes or no

If yes, please explain and include county and state:

Have you ever been refused bond?

WORK EXPERIENCE, SKILLS AND ACTIVITIES:

Are you retired?

Are you employed?

* Current/Former Occupation

Skills

* Work/Volunteer Experience

* Why do you want to become a volunteer?

VOLUNTEER PREFERENCES:

Preferred Shift(s)

Preferred Day(s)

I am interested in:

Department(s) or area of preference (if any)

* I certify I am at least 18 years of age and the above information is correct with no misrepresentations. I also understand there is a commitment of 4 consecutive months of volunteering beginning on my start date.

* Enter your full name as your online signature here:

* Date

If you need assistance or have any questions, please call the facility of your choice:

Cape Coral Hospital (239) 424-2206 - Includes * Surfside * Santa Barbara Business Office * Babcock Ranch

Golisano Children's Hospital of SWFL (239) 343-5055

Gulf Coast Medical Center (239) 343-0636 - Includes * Coconut Point * GCMC Skilled Nursing Unit * Westlinks Office

HealthPark Medical Center (239) 343-5055 - Includes * Healthpark Care and Rehab Center

Lee Memorial Hospital (239) 343-2388 - Includes * The Regional Cancer Center