skip to content, health centers and clinics, search, accessibility statement
Newsroom,    About Us,    Divisions,    Jobs,    Provider Information,    Contact Us,

Adult Volunteer Application


Please fill-up the online form then submit or you may download the Adult Volunteer Application and mail to CCRMC Volunteer Office 2500 Alhambra Avenue, Martinez, CA 94553.

Online Adult Volunteer Application Form

 Area Code first
How did you hear about the CCRMC volunteer program?
EMPLOYMENT:
Current Employment Status:
EMERGENCY CONTACT INFORMATION:
1.
2.
REFERENCES: In order to process your application, it is essential that all information requested below is provided. References should not be from relatives. References from current or past supervisors are preferred.
To provide a quality volunteer program at the Contra Costa Regional Medical Center and to insure that we do our best to match the needs of the Hospital and our Volunteers, we ask a certain amount of detailed information regarding your personal and work related experiences. With this information we are better able to offer you an assignment that can be tailored to your needs as well as ours.
EDUCATION:
ADDITIONAL INFORMATION:
Disclaimer: Applicants will be required to submit an application, participate in a face-to-face interview, provide references for checking, complete a background check, and attend a training program prior to placement. Applicants who provide false information shall be disqualified for, or terminated from service.