I understand that I am applying to be a volunteer, not a paid employee, at JPS Health Network. I understand that I am solely to perform tasks assigned specifically to me. I will wear the required volunteer uniform and JPS identification badge. I allow the Volunteer Services Department to contact my personal references and previous volunteer agencies before I begin volunteering. I authorize JPS to conduct a criminal background check. I understand the importance of Tuberculosis Screening and agree to have two TB tests (administered by JPS at no cost to volunteers) before I begin my volunteer commitment, and one annually thereafter. I understand that the first 30 days of my volunteer service will be considered a probationary period. I will adhere to JPS Health Network and JPS Volunteer Services Department policies and procedures. I agree to accept full responsibility and to hold harmless JPS Health Network, its employees, directors, officers, trustees or agents from any and all claims and damages that may arise from my participation in the volunteer program. I understand that JPS Health Network may terminate my volunteer services for any reason.

By checking this box, I agree that my typed name above shall have the same force and effect as my written signature. This option is available ONLY is submitting application electronically. All other applications submitted by fax, by mail or in person must have actual volunteer signature.