Please fill out this form and submit. If you have any questions please contact the below.

Volunteer Services, Cottage Health
400 W. Pueblo St, PO Box 689
Santa Barbara CA 93102

volunteering@sbch.org
(805) 569-7357 phone
(805) 569-7397 fax

Volunteer Information

Please provide either a home phone number and/or a cell phone number

References

Please provide us with a minimum of 2 professional or personal references.

Reference #1
Reference #2
Reference #3
Reference #4

Please check the areas that interest you.

Creative / Personal Skills
Office / Technical Skills

Briefly describe why you would like to volunteer.

Please mark the times you are available to volunteer.

Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Confirmation

Cottage Health (CH) is an Equal Opportunity Employer. CH does not discriminate on the basis of race, national origin, religion, sex, sexual orientation, age, disability, or any other category protected by applicable federal, state,or local laws.

I understand and agree that in performing my service as a volunteer of CH must hold patient and other confidential information in confidence. I understand that any violation would be grounds for disciplinary action.

I am volunteering my services to CH solely for my personal purposes or benefit without promise or expectation of compensation or benefits. I agree to serve as a volunteer for a 6-month commitment for 100 cumulative hours of service.

I declare that all of the statements in this application are true, correct, and complete to the best of my knowledge and authorize CH to investigate any statements in determining my eligibility for a volunteer position.I understand that falsification or material omission on this application is grounds for rejection of my application or my dismissal from volunteering. I acknowledge that the continuation of my volunteer position is at the consent of the volunteer and the hospital. This volunteer position is terminable at will by either party.
By typing your name below you agree to the above conditions.
If applicant is under age 18, a parent or guardian signature is also required:
***By hitting SUBMIT, this application will be submitted.