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Henry Ford West Bloomfield Hospital Adult Volunteer Applicaton Form
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Volunteer Opportunities
New User Details
User ID
User ID (verify)
Password
Password (verify)
Personal Information
*
At which Henry Ford site(s) are you willing to volunteer? *If you have already been assigned to a site, please select below.
Henry Ford Hospital (Detroit)
Henry Ford Kingswood Hospital
Henry Ford Medical Center - Columbus (Novi)
Henry Ford Medical Center - Cottage / Pierson (Grosse Pointe Farms)
Henry Ford Medical Center - Detroit Northwest
Henry Ford Medical Center - East Jefferson (St. Claire Shores)
Henry Ford Medical Center - Fairlane (Dearborn)
Henry Ford Medical Center - Hamtramck
Henry Ford Medical Center - Harbortown (Detroit)
Henry Ford Medical Center - Lakeside (Sterling Heights)
Henry Ford Medical Center - Taylor
New Center One (Detroit)
One Ford Place (Detroit)
William Clay Ford Center for Athletic Medicine
If the site is not listed, please indicate here.
*
First Name
MI
*
Last Name
*
Preferred Name
*
Home Address
*
City
State/Province
AB
AK
AL
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
*
Zip Code
*
Preferred phone
Type
Home
Mobile
Work
Home phone
Mobile phone
Work phone
*
E-mail
Contact flags
Do not SMS/text message
Emergency Contact Information
*
Contact name
*
Relationship
*
Address
*
City
*
State
Zip Code
*
Home phone
Mobile phone
E-mail address
Additional Information
*
How did you hear about us?
Have you ever been convicted or plead guilty or no contest to a crime?
Yes
No
Do you have any felony charges pending against you?
Yes
No
List of Convictions
Are/were you or a family member an employee or volunteer of HFHS?
Yes I am currently emloyed by HFHS
Yes, I was previously employed by HFHS
Yes, a family member is currently employed by HFHS
Yes, a family member was previously employed by HFHS
Yes, I currently volunteer for HFHS
Yes, I previously volunteered for HFHS
Yes, a family member currently volunteers for HFHS
Yes a family member previously volunteered for HFHS
No
If you or a family member were or are an employee or volunteer of HFHS, please explain here
Volunteer Preferences
Availability
Monday
7am-Noon
Noon-4pm
4pm-8pm
8pm-Midnight
Tuesday
7am-Noon
Noon-4pm
4pm-8pm
8pm-Midnight
Wednesday
7am-Noon
Noon-4pm
4pm-8pm
8pm-Midnight
Thursday
7am-Noon
Noon-4pm
4pm-8pm
8pm-Midnight
Friday
7am-Noon
Noon-4pm
4pm-8pm
8pm-Midnight
Weekend Availability
Sunday
8am-Noon
Noon-4pm
4pm-8pm
8pm-Midnight
Saturday
8am-Noon
Noon-4pm
4pm-8pm
8pm-Midnight
How long can you commit to volunteering:
3 - 6 Months
6-12 Months
More than a year
*
When would you like to begin volunteering?
Last available date to volunteer (if anticipated)
I do not anticipate an end date for volunteering at this time.
Skills
Administration/Office
Artist
Computer - Data entry
Computer - IT general
Crafts
Crocheting
Event Planning
Food Services
Food Services - Preparation
Fundraising
Gardening
Knitting
Language/Translator
Mailings
Musician
Pet Therapy
Photography
Public Speaking
RN
Sewing
Writing/Reporting
Prospect Job Preferences
Observation
*
If you are applying for an Observation, please list the department(s) and medical professional you are observing.
Should you be Observing a Medical Professional please list First and Last name-
Experience & Education
Communication Language
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
Dothraki
Dutch
Ebu
Eggon
Egyptian
Emakua
English
Eskimo
Estonian
Etruscan
Fang
Faroese
Farsi
Filipino
Finnish
Flemish
Frankish
French
Fujanese
Fuzhounese
Gaelic
Gaelic (Irish)
Gaelic (Scottish)
Gaelic (Welsh)
Galician
Gamilaraay
Ganda
Gaulish
Gbari
Georgian
German
Gevove
Gilbertese
Gothic
Greek
Guarani
Gujarati
Guyanese Creole patois
Haida
Haitian
Hakka
Halaka
Hausa
Hawaiian
Hebrew
Hiligaynon
Hindi
Hmong
Hungarian
Icelandic
Igbo
Ilocano
Ilonggo
Indonesian
Ingush
Inupiat
Italian
Japanese
Jita
Kachi
Kakwa
Kalanga
Kannada
Kapampangan
Karelian
Kashmiri
Katcha
Kazakh
Kerewe
Khmer
Khowar
Kiga
Klallam
Klingon
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
Minbari
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
Sindhi
Sinhala
Slovak
Slovene
Sogdian
Somali
Sorbian
Spanish
Sranan
Sudovian
Sumerian
Swabian
Swahili
Swedish
Tagalog
Taishanese
Taiwanese
Tajik
Tamazight
Tamil
Tarahumara
Tarok
Tatar
Telugu
Teochew
Thai
Thracian
Tibetan
Tlingit
Tocharian
Tongan
Treu Chau
Turkish
Turkmen
Twi
Ukrainian
Ulwa
Umbrian
Urdu
Urdu
Uyghur
Uzbek
Venda
Veps
Vietnamese
Visayan
Votic
Warlpiri
Welsh
Wolof
Xhosa
Yaka
Yao
Yemba
Yiddish
Yoruba
Yupik
Zoque
Zulu
Additional languages
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
Dothraki
Dutch
Ebu
Eggon
Egyptian
Emakua
English
Eskimo
Estonian
Etruscan
Fang
Faroese
Farsi
Filipino
Finnish
Flemish
Frankish
French
Fujanese
Fuzhounese
Gaelic
Gaelic (Irish)
Gaelic (Scottish)
Gaelic (Welsh)
Galician
Gamilaraay
Ganda
Gaulish
Gbari
Georgian
German
Gevove
Gilbertese
Gothic
Greek
Guarani
Gujarati
Guyanese Creole patois
Haida
Haitian
Hakka
Halaka
Hausa
Hawaiian
Hebrew
Hiligaynon
Hindi
Hmong
Hungarian
Icelandic
Igbo
Ilocano
Ilonggo
Indonesian
Ingush
Inupiat
Italian
Japanese
Jita
Kachi
Kakwa
Kalanga
Kannada
Kapampangan
Karelian
Kashmiri
Katcha
Kazakh
Kerewe
Khmer
Khowar
Kiga
Klallam
Klingon
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
Minbari
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
Sindhi
Sinhala
Slovak
Slovene
Sogdian
Somali
Sorbian
Spanish
Sranan
Sudovian
Sumerian
Swabian
Swahili
Swedish
Tagalog
Taishanese
Taiwanese
Tajik
Tamazight
Tamil
Tarahumara
Tarok
Tatar
Telugu
Teochew
Thai
Thracian
Tibetan
Tlingit
Tocharian
Tongan
Treu Chau
Turkish
Turkmen
Twi
Ukrainian
Ulwa
Umbrian
Urdu
Urdu
Uyghur
Uzbek
Venda
Veps
Vietnamese
Visayan
Votic
Warlpiri
Welsh
Wolof
Xhosa
Yaka
Yao
Yemba
Yiddish
Yoruba
Yupik
Zoque
Zulu
Highest education
College Grad (2-year)
College Grad (4-year)
College Grad (Doctoral)
College Grad (Masters)
College Student
Elementary Student
Graduate Student
High School Grad
High School Limited
High School Student
Home Schooler
Jr. High Student
Seminary Student
Skilled Trade Grad
Special - CBOT
Special - CLC
Special - KVOT
Unknown
I attend or attended school/college:
Employment History
I am employed.
I work at (employer):
1. Organization
Employee Job Title
Job Duties
Length of Employment
Less than 1 year
1 to 2 years
2 to 5 years
More than 5 years
2. Organization
Employee Job Title
Job Duties
Length of Employment
Less than 1 year
1 to 2 years
2 to 5 years
More than 5 years
Volunteer Experience
1. Organization
Volunteer Job Title
Job Duties
Length of Service
Less than 1 year
1 to 2 years
2 to 5 years
More than 5 years
2. Organization
Volunteer Job Title
Job Duties
Length of Service
Less than 1 year
1 to 2 years
2 to 5 years
More than 5 years
Comments & Other Info
Do you agree to be tested for TB and have a seasonal flu vaccine?
Yes
No
*
What do you hope to do as a volunteer?
Any additional information for us to consider?
*
I certify that responses on my online application are true to the best of my knowledge. I agree that this information may be verified and references contacted by Henry Ford Detroit Hospital. Misrepresentation of facts constitutes cause for separation from Volunteer Services. (Please electronically sign below)
