Please note: this form is for those over 18 or out of high school.
High school application packets are available by calling 330.344.6351.

Please Enter the Required Information

Your application will not be received if the required fields (marked *) are not complete. 
Once you've completed the form and clicked "Submit, " an email will be returned to you verifying the receipt of your information. The information entered on this page is completely confidential and secure.

I am applying for a position at:
Applicant Information
Format: xx/xx/xxxx
Format: XXX-XXX-XXXX (use dashes)
Format: XXX-XXX-XXXX (use dashes)
If an e-mail address is given, a confirmation will be sent to the e-mail address.
Individuals who have experienced a recent loss are encouraged to wait a minimum of one year before volunteering in a patient contact capacity. However, they are encouraged to volunteer for non-patient contact duties at any time.
Please list the hours available and indicate a.m. or p.m.
Please list organizations/Agencies With Which You Have Volunteered
Format: XXX-XXX-XXXX (use dashes)
Format: XXX-XXX-XXXX (use dashes)
References: List two persons that we may contact for a character reference (excluding relatives)
Format: XXX-XXX-XXXX (use dashes)
Format: XXX-XXX-XXXX (use dashes)
Emergency Info: In Case of Emergency, Call
Format: XXX-XXX-XXXX (use dashes)
Confirmation (see details below submit button)

Qualified applicants are considered for all positions without regard to race, religion, sex, national origin, age, marital or veteran status, or the presence of a non-related medical condition, handicap or any other legally protected condition.

I acknowledge that the Cleveland Clinic Akron General Visiting Nurse Service will conduct required searches of federal exclusionary lists to include the Office of Foreign Asset Control, General Services Administration, and Health and Human Services.

Akron General is not obligated to provide volunteer placement, nor are you obligated to accept the volunteer position offered.

I understand that I am required to complete the volunteer orientation, comply with the mandatory Two-Step Mantoux Tuberculosis screening, and adhere to annual training as required by Akron General. I further understand that by accepting a volunteer position, I will be expected to abide by all rules, regulations and policies of Akron General Medical Center and the Volunteer Services Department.

Selecting the box below affirms all facts set forth in my application for volunteering are true and complete. I understand that if accepted, false statements, omissionsor other misrepresentations by me on this application may result in immediate dismissal.