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Solicitud de voluntario
médico sin licencia

Thank you for your interest in volunteering with Project LINK and the Back to School Coalition of Hillsborough County's "Back-2-School Health Clinics". As we transition into a post-pandemic workplace, our top priority is the health and safety of all employees, volunteers, and visitors.

 

We are committed to creating a safe and healthy work environment by implementing the following measures: we are requiring all volunteers to answer the COVID-19 questionnaire before entering the site properties, as well as frequent hand sanitizing between client visits. To maximize safety on campus, it is our agency policy to screen all applicants via sexual predator/offender background checks. Submission of this application indicates your agreement to this background check. Volunteer hours are from 7:30 am - 3:00 pm.

Which volunteer position below are you interested in?
List two personal references not related to you whom you have known for more than one year:
List your most recent volunteer or employment experience:
Dates of Volunteer/Employment
Select the Back-2-School Health Clinic Site(s) you will support?  |  Volunteer Hours: 7:30am - 3:00pm

BEFORE CONTINUING PLEASE VERIFY YOU HAVE SELECTED AT LEAST ONE SITE TO VOLUNTEER

Have you ever been convicted of, or plead nolo contendere, to a driving or criminal offence?
It shall be a misdemeanor of the first degree to fail to disclose (by false statement, misrepresentation, impersonation, or other fraudulent means), any material fact that would be used in making a determination as to a person's qualifications to work as a volunteer.

I understand that, to protect persons served by the Department, a routine check through law enforcement, license bureaus, agency files, and references may be made. I understand that a criminal offense will not automatically exclude me from all volunteer positions; however, certain convictions will exclude me from volunteering in some positions. I understand that if I answered "no" to the criminal offense question on the front of this application, and a record should be obtained, it will prevent me from volunteering for the Department regardless of the offense. I understand upon submission of this application it becomes public record. I understand and agree that all information as it relates to persons served by the Department is to be held confidential in compliance with Florida Statutes. All information that should come to my attention and knowledge as "privileged" and/or "confidential" will not be disclosed to anyone other than authorized personnel, and I shall conduct myself in accordance with the

Department's security policies. I understand that failure to comply may result in criminal prosecution.

 

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