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NEA Baptist
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Application for Hospital Volunteers
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Health Tip
Use low-fat dairy products - nonfat/skim milk, low-fat cheeses, low-fat yogurt, and low-fat dairy desserts."

Daily Bread
Do not merely listen to the word...Do what it says.
James 1:22
Name:
Phone:
Mailing Address:
City:
State:
Birthday
If married, name of spouse:
Person to be contacted in case of emergency or illness on duty:
Name:
Relationship:
Home Phone:
Employer:
Business Phone:
PREVIOUS VOLUNTEER EXPERIENCE
Name & Location:
Describe Responsibilities:
Major Area of Interest and/or Education:
Do you have special skills you would like to use in your volunteer work? If so, please describe.
Do you have friends or relatives that volunteer or are employed at NEA Baptist?
yes
no
If yes, who?:
Scheduling Preferences
Preferred time to work (specify morning, afternoon, or specific hours):
Are there certain days that you are not available?:
Please check preferred work days
Monday
Tuesday
Wednesday
Thursday
Friday
References
Name:
Phone:
Name:
Phone:

By checking the box below I agree that if accepted as a volunteer at NEA Baptist, I will uphold all hospital and volunteer policies. I also agree to a reference check within 30 days of being accepted. (For more information contact our Auxiliary President.)

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NEA Baptist Memorial Hospital
3024 Stadium Blvd.
Jonesboro, AR 72401
870-972-7000
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Baptist Memorial Hospital In keeping with the three-fold ministry of Christ — healing, preaching and teaching — Baptist Memorial Health Care Corporation is committed to providing quality health care.