Volunteer Application

Thank you for your interest in volunteering at Good Shepherd Rehabilitation Network. A volunteer is a person who willingly offers to serve Good Shepherd without the expectation of compensation or payment.

To volunteer at Good Shepherd, you must:

  1. Complete and submit the following form
  2. Have no criminal record. A background check will be performed after your application is received.
  3. Have an interview with Good Shepherd’s Coordinator of Volunteers, where you will discuss your interests, the volunteer opportunities available and other issues. After submitting your application you will be contacted to schedule an interview.
  4. Have a clear (within one year) TB test. Good Shepherd will provide this at no cost.

GOOD SHEPHERD VOLUNTEER APPLICATION

Please complete and submit the following application. If you would rather have a hard-copy application mailed to you, please contact us.

Personal Information
We are dedicated to accommodating all volunteers, regardless of disability or functional limitations.
Employment History
In Case of Emergency, Please Notify
References
(List two non-family references who have known you for at least one year. A Request for Reference form will be sent to the individuals listed. These forms must be returned before your interview is scheduled.)
Education
School Information
Areas of Interest/Skills
Volunteer Information
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Volunteer Agreement
I hereby authorize and permit Good Shepherd Rehabilitation Network to obtain any records or documents pertaining to my background, including a criminal background check, which will require me to provide my social security number and my date of birth. Good Shepherd Rehabilitation Network abides by the federal Civil Rights Act and the Pennsylvania Human Relations Act. If I am accepted as a Good Shepherd Rehabilitation Network volunteer, I will maintain the schedule to which I have agreed. I will attend such in-services as are required to maintain my qualifications as a volunteer, and I will maintain strict confidentiality concerning all information regarding clients, patients and residents. I agree to have an annual TB test to be provided by Good Shepherd Rehabilitation Network at no expense to me or to have the test done elsewhere at my own expense.
Guardian Information
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