Welcome to Volunteer Services

Please fill out this form to volunteer with us.

CHAPEL HILL ADULT & GRAD STUDENT APPLICATION - (Main hospital campus & offsite clinics)

Application Date
Last name
Legal First Name
Nickname
Middle Name
Group
E-mail
Additional languages
Gender (optional)
Ethnic Background (optional)
Date of Birth (optional)
Permanent Address
Street
City
State
Zip
Home phone
Cell Phone
Vehicle Info (or enter N/A if UNC student,or UNCH or University Employee):
Vehicle Make
Plate Number
Model/Color
Highest Degree Attained
Degree
Current Grad Students
School
Program of Study
Are you employed at UNC Health Care? If yes, where?
Current Occupation
Employer
Volunteer Service Areas Preferred (Opportunities Page - Volunteer Website)
Choice 1
Choice 2
Choice 3
Days and Hours Available
Emergency Contact Name
Phone
How did you learn about Volunteer Services?

APPLICANT AUTHORIZATION

I hereby authorize a Consumer Reporting Agency (CRA) chosen by UNC Health to perform a criminal record search and to allow UNC Health access to those results

I understand that the CRA does not guarantee the accuracy or timeliness of the information obtained from other sources and that UNC Health and the CRA shall not be liable for any inaccuracy in the information obtained from the CRA.

I understand that I must obtain a criminal background check from an agency chosen by UNC Health.
I understand by completing this application that I agree to a minimum of 6 months of volunteer service with UNC Health Care.