Volunteer Application Agreement

I understand that acceptance and placement into positions within volunteer services is contingent on the successful completion of a background investigation and successfully completing all required post offer medical health checks prior to the first day of volunteering. You must also successfully complete all new volunteer paperwork, including verification of your legal right to work in the United States of America.

I hereby certify that the information contained in this application form is true and correct and agree to have any of these statements checked by UCI Medical Center unless I have indicated to the contrary.I authorize the references listed above, as well as other individuals whom UCI Medical Center contacts, to provide the Medical Center any and all information concerning my previous employment and other pertinent information that they may have. In addition, I authorize the Medical Center, any related entity, and their respective employees and agents to request and receive any information and records concerning me, including but not limited to: records regarding professional or vocational licenses or certifications, criminal convictions, driving, military service, civil and educational data and reports from any individuals, corporations, partnerships, associations, institutions, schools, governmental agencies and department, courts, law enforcement and licensing agencies, public agencies, private organizations and other entities. Further, I release all parties and persons from any and all liability for any damages that may result from furnishing such information to UCI Medical Center as well as from the use or disclosure of such information by the Medical Center or any of its agents, employees or representatives.

I understand that acceptance and placement into specific positions within volunteer services is conditioned upon the successful completion of a criminal background investigation, medical examination, receipt of satisfactory responses to reference requests and as may be required by the University policy the provision of satisfactory proof of an applicant's identity and legal authority to work in the United States.

I understand that I am applying for an unpaid, volunteer position and not paid employment. I understand and agree that neither this volunteer application nor the acceptance or performance of a volunteer position constitutes an employment relationship or a contract of employment. I further understand and agree that neither this volunteer application nor the acceptance or performance of a volunteer position constitutes a guarantee or promise of future employment.

I understand that if I accept a volunteer position, I will have a duty to be familiar with UCI Medical Center rules, standards and policies as they now exist or as they may be modified, added to, or abolished in the future. I agree to comply with and follow these rules, standards and policies.

I agree to wear the designated volunteer uniform and ID badge at all times while volunteering in the medical facility.

I understand that any misrepresentation, falsification or material omission may result in failure to be accepted for a position in volunteer services, or if already in a position, may lead to immediate removal from that position.

I understand that I am committing to 100 hours of service typically done in a minimum of three-hour shifts once a week.