If you are an adult, you can fill out the online form below or print out the
fill it out and mail or fax it to us. Our address and fax number are on the bottom of the application.
Recent Volunteer Experience :
Please explain how you decided to contact Upstate and any expectations you might have about volunteer service.
A typical commitment is one 4-hour shift per week, on a regular schedule (ex. 12pm-4pm Thursdays). Please list any schedule preferences you have:
Do you expect to travel or for some other reason be unavailable for extended periods of time in the coming year(s)? If so, explain:
Except for minor traffic violations, have you ever been convicted of an offense of law? (i.e. Criminal, Misdemeanor or Felony.) (Convictions shall include a plea, verdict, or finding of guilt, regardless of the sentence imposed by a court of law.) A conviction will not automatically bar consideration for volunteer opportunities. If yes, please include the date, location of court, type of violation, misdemeanor or felony conviction for each offense, and explain the details of the situation:
I submit my name for consideration to volunteer at University Hospital. I understand that, ideally my association as a volunteer will extend far into the future, but a commitment of at least 100 hours is expected during the first 6 months of service. In addition, the college volunteer program is based on a per semester basis and requires a 50 hour commitment per semester.