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Volunteer Application Form

Thank you for your interest in becoming a Versiti volunteer. Because of the dedication and generosity of volunteers like you, we are able to provide life-saving products to patients in the communities we serve.

If you enjoy being with people, have great customer service skills, and are willing to share your talents and passions with our donors and patient families, we invite you to begin the application process.

In order to become an Versiti volunteer, you must:

  • Be at least 17 years old
  • Understand that a criminal background check will be performed
  • Attend a volunteer placement interview

Please note that all information submitted on this Volunteer Application Form will be kept confidential and will only be used by Versiti Volunteer Services.

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References

List two people not related to you who can attest to your character. A personal reference cannot be one from a family member.

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Commitment & Obligation

What length of commitment are you willing to make? (Note: We ask that you be willing to volunteer at least 4 hours per month and us at least a 6 month commitment.)

Will this volunteer position fulfill an obligation for community service or a school/church assignment? If so, How many hours are required for this assignment? (Note: We do not accept volunteers with court ordered community service.)


Please select the Versiti blood center you would like to volunteer at:

Wisconsin Interests:










Background Check – Authorization Waiver and Release Statement

We are grateful for your application to become a volunteer. Please note the background checks are performed on all potential volunteers.

When you check the “I AGREE” box below you are indicating that you understand that a criminal background check will be done with the Department of Justice, without liability to Versiti.

All of the information above is, to the best of my knowledge and belief, true, correct and complete. I understand a false answer to any question on this application is grounds for termination of the application process, or dismissal from Versiti’s Volunteer Program.


 

* Required field.

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