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
    Emergency Contact Information
    Name
    Relationship to You
    Home Phone
    Cell Phone
    History
    Have you ever been convicted of a crime?
    If yes, please explain:
    Are you eligible to work in US?
    Are you a US Citizen?
    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?
    If yes, please list the dates, role, entity, and department you worked in.
    Have you ever volunteered at Spectrum Health?
    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
    Where are you interested in volunteering?
    How did you hear about us?
    How long are you willing to commit to volunteer?
    Availability (check all that apply)
    References
    Reference #1
    Name
    Relationship
    Address 1
    City
    State
    Zip/Postal
    E-mail
    Phone
    Reference #2
    Name
    Relationship
    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.