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Volunteer Application
Thank you for considering Community Health Center of Cape Cod as a place to donate your time and talents. Volunteers play an important role in the history and current operations of the Health Center. Please take a few minutes to fill out this application, so that we may begin to match your skills and interests with the opportunities available.

Name: *
Your answer
Home Address: *
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Home Phone/Cell Phone: *
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Email Address: *
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Emergency Contact & Phone Number: *
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Which volunteer positions interest you? (Check all that apply). *
Required
Days of the week available to volunteer. (Check all that apply). *
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Time of day available to volunteer. (Check all that apply). *
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How did you hear about CHC of Cape Cod? (Check all that apply). *
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Hours per week you can volunteer (minimum 4) *
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Describe any past educational or work experiences that might benefit you as a volunteer at CHC of Cape Cod: *
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Resume Included (please paste below):
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Are you under the age of 18? *
References who can attest to your character and dependability (please do not list relatives). Please include name/phone/relationship to you: *
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Please read the following before signing this application: I certify that the information contained in this application is correct to the best of my knowledge. I understand that to falsify information is grounds for refusing my volunteer application. I authorize The Community Health Center or any of its agents, at any time prior to or during my employment, to: a) investigate my references; b) communicate with my former employers; c) conduct an independent investigation of my character, conduct and employment record, including, without limitation, a criminal background check. Your typed signature below will serve as your legal signature: *
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