TCAB Nursing Application

Transforming Care at the Bedside (TCAB) Volunteer Program Application

Thank you for your interest in volunteering at Cedars-Sinai and becoming a TCAB Volunteer. If you experience any problems while submitting this application, please email us immediately at TCAB Volunteer Program.

If you have previously submitted an application, previously volunteered, or are a current employee at Cedars-Sinai, please call our office at 310-423-8044 before submitting a new application.

If you have applied or are currently participating in any research or internship opportunities at Cedars-Sinai, please call our office at 310-423-8044 before submitting an application.

New User Details

User ID

User ID (verify)

Password

Password (verify)

Please be sure to answer ALL questions before submitting.

* By checking this box, I confirm that I am available to volunteer at least once a week for the next 6 months.

* By checking this box, I confirm that I am able to complete a minimum of 100 hours of uninterrupted weekly volunteer service.

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

* Identification Verification:

Please input your name as it appears on your legal documentation.

* First Name

Middle Name

* Last Name

* Home Address

* City

State

* Zip Code

Home Phone

* Cell Phone

Work Phone

* E-mail Address

* Date of Birth (MM/DD/YYYY)

Pronouns:

What is your gender identity?

If self-describing gender identity, please specify:

EMERGENCY CONTACT

In case of an emergency, whom do you wish to be notified:

* Name of Emergency Contact

* Relationship

Home Phone

* Mobile 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 tcabvolunteerprogram@cshs.org to describe your details.

Do you have any physical or mental disabilities that would impair your ability to perform as a volunteer in the Medical Center without any supplemental assistance? An affirmative response will not automatically disqualify you from being considered.

If yes, please provide details below:

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 any of the categories below apply to you?

Do you have any friends and/or relatives employed or volunteering at Cedars-Sinai Medical Center:

Name:

Relationship:

Department:

Name:

Relationship:

Department:

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

Name of Employer:

Business Address:

City/State/Postal:

Describe Job Duties:

VOLUNTEER EXPERIENCE

Have you previously applied or volunteered at Cedars-Sinai Medical Center?

*How did you hear about us? (Please select all that apply.)

If Other, how did you hear about us?

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

Name of Volunteer Organization

Type of Duties Performed

Date Started

Date Ended

Name of Volunteer Organization

Type of Duties Performed

Date Started

Date Ended

EDUCATION AND INTERESTS

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:

Current Educational Institution, please select one of the following:

* Name of Current Educational Institution - indicate N/A if not enrolled

Are you currently enrolled or planning to enroll in one or more of the following?

If Other, please explain:

* How does your desire to volunteer now relate to your future career or educational goals?

* What type of volunteer experience are you interested in at Cedars-Sinai?

* 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.  

Application completed on: