Medical Center Volunteer Information Request Form May 19, 2016 Yes, I want to learn more about volunteering at San Mateo Medical Center! First name: * Last name: * Cell phone number: Home phone number: Work phone number : Email address: * I am an adult: Yes No I am a student (at least 15 years old): Yes No I am interested in (check all that apply): Working in a clinic, hospital department, or Long-Term Care Helping in the gift shop Working at the information desk Doing clerical work Helping with a special event I’m not sure yet Other Other: I am available (check all that apply): Monday – Friday, days Monday – Friday, nights Weekend days Weekend nights I’m not sure yet My employer offers matching funds for volunteer hours: Yes No