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Application to Join the WHC Volunteer Program

We appreciate your interest in becoming a Wesley Health Centers volunteer. At WHC, you will find a wide range of opportunities in which to participate. We also offer Community Service Credit for any Court Ordered Volunteer Services.

Because of the diversity of our volunteer opportunities, concern for the health and well being of our clients, volunteers and staff, and depending upon which area you decide to assist in, there may be several forms for you to complete. Thank you for your patience and understanding.

Please be advised that some programs require a Health Assessment examination, which includes (but is not limited to) a T.B. (Tuberculosis) test. The Health Assessment can be done on site at JWCH by trained professionals at no cost to the volunteer.

Volunteer Application

Please fill out this form completely, and we will follow-up soon.
  • MM slash DD slash YYYY
  • Which State issued your drivers license/I.D.?
  • If you are under 18 years of age, can you provide required proof of your eligibility to work?
  • On what date are you available to volunteer?
  • What days and hours are you available to volunteer?
    Information will be kept confidential. Conviction will not necessarily disqualify an applicant.
  • Please list any specific skills, talents and computer knowledge that might be useful in your volunteer work.
  • Please list any additional information you feel may be helpful to us in considering your application.
  • If you speak or write any languages other than English, please provide detail.
  • Please list at least three (3) references. (At least One for each of the categories.)
  • Describe how long you've known this person and your relationship with them.
  • Describe how long you've known this person and your relationship with them.
  • Describe your relationship with this organization, including duties performed and dates of employment.
  • Describe your relationship with this organization, including duties performed and dates of employment.
  • Describe your volunteer assignments and length of time you served with this agency.
  • Describe your volunteer assignments and length of time you served with this agency.
    I certify that all answers given herein are true and complete to the best of my knowledge. I authorize the investigation of all statements contained in this volunteer application as may be necessary in arriving at a decision. In the event of volunteer employment, I understand that false or misleading information given in my application or interview may result in discharge. Additionally, I understand that I am required to abide by all rules and regulations of JWCH Institute, Inc.

QUESTIONS? NEED ASSISTANCE?

If you have any questions, please call us at: 1-866-733-5924.

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No one is turned away due to lack of ability to pay for services or due to being uninsured
We also offer a sliding fee schedule for persons at or below 200% of Federal Poverty Income Guidelines.

The Health Resources and Services Administration (HRSA) consider JWCH Institute, Inc. / Wesley Health Centers and its providers as Public Health Services employees, providing malpractice liability protection under the Federal Tort Claims Act (FTCA). This health center is a Health Center Program grantee under 42 U.S.C. 254b, and a deemed Public Health Service employee under 42 U.S.C. 233(g)-(n).

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