Welcome to Spectrum Health Fuller Volunteer Services
Fuller Application
Spectrum Health Volunteer Application
Rehab and Nursing Center- Fuller Ave.
By continuing the application, I acknowledge that:
I am at least 18 years old
I am able to commit for at least six months
I am willing to complete medical requirements such as Tuburculosis skin tests, immunizations, blood draws and the seasonal flu vaccination
Personal Information
First Name
Middle Name
Last Name
Preferred Name
Date of Birth
Current Address
Address Line 1
Address Line 2
City
State
Zip/Postal
Permanent Address (only if different than current)
Address Line 1
Address Line 2
City
State
Zip/Postal
Contact Information
Preferred Email Address
Home Phone
Mobile
Work Phone
May We Text You? (Check if Yes)
Preferred Phone Number
Home Phone
Mobile
Work
Emergency Contact Information
Name
Relationship to You
Home Phone
Cell Phone
History
Have you ever been convicted of a crime?
Yes
No
Other
If yes, please explain:
Are you eligible to work in US?
Yes
No
Are you a US Citizen?
Yes
No
If no, documentation may be required at a later time.
Education/Employment
Are you required to volunteer (i.e. high school or college requirement)?
Please explain:
Are you receiving credit for volunteering (i.e. college course)? Check box if yes.
Please explain:
Have you ever been employed by Spectrum Health?
No
Yes currently employed by SH
Yes employed by SH in the past
If yes, please list the dates, role, entity, and department you worked in.
Have you ever volunteered at Spectrum Health?
No I have never volunteered with Spectrum Health
Yes currently a volunteer at a different location
Yes I have volunteered with Spectrum Health in the past
If yes, please list the dates, role, entity, and department you volunteered in.
If you have worked or volunteered at Spectrum Health under a different name (i.e. maiden name), please list it below:
Is there any employement and/or volunteer experience you would like to share with us?
Volunteer Interest
Please explain your interest in volunteering at Spectrum Health:
Additional Languages Spoken
Afrikaans
Akan
Aklanon
Albanian
Algerian
Amharic
Arabic
Arawakan
Armenian
ASL
Avestan
Ayapathu
Aymara
Azeri
Bamwe
Bantu
Basa
Basque
Belarusan
Bemba
Bengali
Berber
Bicol
Bisaya
Bobangi
Bosnian
Brahui
Breton
Bukusu
Bulgarian
Burmese
Butuanon
Byelorussian
Cambodian
Cantonese
Catalan
Cayuga
Cebuano
Ch'ol
Chaldean
Chamorro
Chechen
Chewa
Chinese
Chinook
Chorti
Coptic
Cree
Creole
Croatian
Czech
Danish
Dari
Demonh'ka
Dutch
Eggon
Egyptian
Emakua
English
Eskimo
Estonian
Etruscan
Fang
Faroese
Farsi
Filipino
Finnish
Flemish
Frankish
French
Gaelic
Gaelic (Irish)
Gaelic (Scottish)
Gaelic (Welsh)
Galician
Gamilaraay
Ganda
Gaulish
Gbari
Georgian
German
Gevove
Gilbertese
Gothic
Greek
Guarani
Gujarati
Guyanese Creole patois
Haida
Hakka
Halaka
Hawaiian
Hebrew
Hiligaynon
Hindi
Hmong
Hungarian
Icelandic
Igbo
Ilocano
Ilonggo
Indonesian
Ingush
Inupiat
Italian
Japanese
Jita
Kachi
Kakwa
Kalanga
Kannada
Kapampangan
Karelian
Katcha
Kazakh
Kerewe
Khmer
Khowar
Kiga
Klallam
Kongo
Konkani
Korean
Koyo
Kurdish
Lakhota
Latin
Latvian
Lebanese
Lingala
Lithuanian
Lozi
Luganda
Luwian
Lycian
Lydian
Mabwe
Macedonian
Malay
Malayalam
Maliseet
Maltese
Mandarin
Mandinka
Manx
Maori
Mapudungun
Marathi
Masaba
Mawu
Mayan
Mayangna
Miami
Miskitu
Mixtec
Mohawk
Mongolian
Mpongwe
Nahuatl
Nande
Nauruan
Navajo
Ndebele
Nepali
Norwegian
Nyamwezi
Occitan
Ojibwe
Olkola
Olutec
Onondaga
Oriya
Oykangand
Pahlavi
Pakahn
Pali
Papiamento
Pashto
Pende
Persian
Phoenician
Phrygian
Pidgin
Piraha
Polish
Popoluca
Portuguese
Potawatomi
Prussian
Punjabi
Quechua
Rasta
Rejang
Romanian
Romany
Rotuman
Russian
Saanich
Sanskrit
Seneca
Serbian
Seri
Shanghainese
Shi
Shona
Signing Exact English
Sinhala
Slovak
Slovene
Sogdian
Somali
Sorbian
Spanish
Sranan
Sudovian
Sumerian
Swabian
Swahili
Swedish
Tagalog
Taiwanese
Tajik
Tamazight
Tamil
Tarahumara
Tarok
Tatar
Telugu
Thai
Thracian
Tibetan
Tlingit
Tocharian
Tongan
Treu Chau
Turkish
Turkmen
Ukrainian
Ulwa
Umbrian
Urdu
Uyghur
Uzbek
Venda
Veps
Vietnamese
Visayan
Votic
Warlpiri
Welsh
Wolof
Xhosa
Yaka
Yao
Yemba
Yiddish
Yupik
Zoque
Zulu
Where are you interested in volunteering?
Education
Expressive Arts
Friendly Visitor
General
Music Visitor
Patient/Resident Menu's
Recreation Therapy
Recreation Therapy Outings
Socialize and clean cage of the bunnies
Spiritual Visitor
Transporter
How did you hear about us?
Calvin College
Church
Cornerstone College
Employer
Friend
GVSU Volunteer Fair
Other
TV/Radio
How long are you willing to commit to volunteer?
6 Months
1 Year
More than 1 year
Availability (check all that apply)
Sunday Morning
Sunday Afternoon
Sunday Evening
Monday Morning
Monday Afternoon
Monday Evening
Tuesday Morning
Tuesday Afternoon
Tuesday Evening
Wednesday Morning
Wednesday Afternoon
Wednesday Evening
Thursday Morning
Thursday Afternoon
Thursday Evening
Friday Morning
Friday Afternoon
Friday Evening
Friday Evening
Saturday Morning
Saturday Afternoon
Saturday Evening
References
Reference #1
Name
Relationship
Parent
Employer
Pastor/religious leader
Law enforcement
Relative
Friend
Teacher
Professional
Personal
Other
Address 1
City
State
Zip/Postal
E-mail
Phone
Reference #2
Name
Relationship
Parent
Employer
Pastor/religious leader
Law enforcement
Relative
Friend
Teacher
Professional
Personal
Other
Address 1
City
State
Zip/Postal
E-mail
Phone
Agreement and Electronic Signature
I agree that:
I am at least 18 years of age
I can commit to volunteer for a weekly shift for at least six months
I will complete all of the necessary paperwork and medical requirements
I understand that:
My application will not be reviewed until 2 letters of reference have been received by Volunteer Service. Your confirmation e-mail will provide you with the mailing address for the reference letters.
It may take several weeks to review my file
Spectrum Health may not be able to find a role that fits my interests
Some roles have a waiting list
Electronic Signature (type your full legal name in the box below)
Thank You for taking the time to fill out an application to volunteer at Spectrum Health!
Please click "Submit my Application" below. You will receive a confirmation message on your screen, as well as to your email.