General Adult Volunteer Application - Marina Del Rey Hospital

Adult Volunteer Application

Thank you for your interest in volunteering at Cedars-Sinai. Please note that our programs require a minimum of 6-month or 100-hour commitment, whichever comes first. If you are interested and can meet this requirement, kindly take a moment to complete your online application to become an Adult Volunteer.

If you experience any problems while submitting this application, please email us immediately at Adult Volunteer Program. If you have previously volunteered or submitted a volunteer application at Cedars-Sinai, please call our office at 310-423-8044 before submitting a new application.

New User Details

User ID

User ID (verify)

Password

Password (verify)

Please be sure to answer ALL questions before submitting.

Please upload a picture of your valid, government-issued identification (e.g., driver's license, REAL ID, passport, etc).

* Identification Verification:

To ensure the safety and health of the whole community, Cedars-Sinai requires all prospective volunteers to be fully vaccinated against COVID-19 in order to apply. You are considered fully vaccinated after the receipt of ONE of the following:

i. Completion of a primary series (original vaccine) AND a single monovalent booster dose, OR

ii. A single bivalent COVID-19 vaccine dose (2022-2023 formulation), OR

iii. A single updated COVID-19 vaccine dose (2023-2024 or later formulation)

If you are not yet eligible for your booster, please email adultvolunteerprogram@cshs.org.

* Please upload a picture or scanned copy of your COVID-19 Vaccination proof.

Upload file:

Vaccine Brand

* Vaccination Date 1

Vaccination Date 2

Booster Brand

Vaccination Date 3

Please input your name as it appears on your legal documentation

* First Name

Middle Name

* Last Name

Preferred Name

* DOB (MM/DD/YYYY)

Check box if you live more than 25 miles away.

* Home Address - include apt./suite # here

* City

State

* Zip Code

Home Phone

* Cell Phone

Work Phone

* E-mail Address

Pronouns

What is your gender identity?

If self-describing gender identity, please specify:

EMERGENCY CONTACT

* Name of Emergency Contact

* Relationship

* Mobile Phone

Home Phone

PERSONAL INFORMATION

* Can you furnish proof of identity and that you are a U.S. Citizen or otherwise legally permitted to take a volunteer position in the United States?

* Social Security Number (000-00-0000) or F1 Visa Number:

If you have neither Social Security Number nor F1 Visa Number, please place zeroes in the blank above and email adultvolunteerprogram@cshs.org to describe your details.

* Do you have any physical limitations that would impair your ability to perform as a volunteer without supplemental assistance?

What languages do you speak? (Please select all that apply.)

How would you identify your race, ethnic, or family origin?

If self-describing race/ethnicity/family origin, please specify:

What is your sexual orientation?

If self-describing sexual orientation, please specify:

EMPLOYMENT INFORMATION

Do you have any friends or acquaintances employed or volunteering at Cedars-Sinai?

* Name (N/A if none)

Relationship

Department

* Name (N/A if none)

Relationship

Department

Do any of the categories below apply to you?

* Are you currently employed? Name of Company or N/A if not currently employed.

Employer's Address

* Describe Job Duties (N/A if not currently employed)

VOLUNTEER EXPERIENCE

* Have you ever submitted a volunteer application or volunteered at Cedars-Sinai Medical Center? If yes, please explain below.

Please list any volunteer experience below. Does not need to be healthcare related.

* Name of Volunteer Organization (N/A if none)

Date Started

Date Ended

* Type of Duties Performed (N/A if none)

* Name of Volunteer Organization (N/A if none)

Date Started

Date Ended

* Type of Duties Performed (N/A if none)

EDUCATION AND INTERESTS

* Name of Highest Educational Institution

* Completed Degree

As a volunteer, we ask that you are able to commit to one four-hour shift each week, with some roles available evenings and weekends. Volunteer placement depends upon the needs of the Medical Center.

Shift Preference:

Shift Time Preference:

STATEMENT OF INTEREST

How did you hear about us:

If Other, how did you hear about us?

Are you pursuing or exploring a career in healthcare?

Are you submitting this application with the intentions of applying to the Pre-Med Volunteer Program?

Please check off your motivations or interests in volunteering (check all that apply):

If Other, please elaborate on your motivations:

* What in your life has influenced you to volunteer?

APPLICATION VERIFICATION

* I hereby affirm that the information provided on this application is true and complete to the best of my knowledge and agree to have any of the statements checked by the organization. I understand that providing any false or misleading information or any omissions may disqualify me from further consideration as a volunteer and may result in my immediate termination, even if discovered at a later date.  

* I authorize representatives of Cedars-Sinai to conduct a thorough investigation of all my activities. I agree to cooperate in such investigation, and release from all liability or responsibility of the organization, all persons and entities acting on its behalf, and all persons and entities requesting or supplying such information.  

Acknowledgement Date