I certify that the answers and information said above are true, accurate and complete to the best of my knowledge. I acknowledge that if any answer or information is not true, accurate or complete, I may not be asked to participate in the volunteer program.
I authorize Physicians’ Clinic of Iowa to investigate all statements contained in this application for employment to include criminal, child and dependent adult abuse information in accordance with Iowa law, as well as my character and qualifications. I release Physicians’ Clinic of Iowa from all liability for actions performed in good faith and without malice in connection with evaluation of my application. I authorize my prior employers, references, and others with information regarding my work, educational history or my character, to provide Physicians’ Clinic of Iowa with all information requested and to cooperate fully with the investigation of my character and qualifications. I agree to cooperate in such an investigation, and release from all liability and/or responsibility all persons, companies, or corporations supplying such information.
I understand, as a volunteer, I must conform to all Physicians’ Clinic of Iowa rules and regulations. I certify that throughout the selection process, including the interview, I will provide information that is true, correct and complete to the best of my knowledge. I certify that I have and will answer all questions to the best of my ability and that I have not and will not withhold any information that would unfavorably affect my application for a volunteer assignment.
I understand that misrepresentations or omissions many be cause for my immediate rejection as an applicant for a volunteer position at Physicians’ Clinic of Iowa Medical Pavilion or my termination as a volunteer. I also understand that this is an application for and not a commitment or promise of volunteer opportunity. I understand that if I am offered a volunteer assignment, the offer is contingent upon satisfactory references, background screening and drug testing. Physicians’ Clinic of Iowa Medical Pavilion seeks to provide a healthy, comfortable, and productive work and health care environment. In the event I am a volunteer of Physicians’ Clinic of Iowa Medical Pavilion, I acknowledge and agree to abide by Physicians’ Clinic of Iowa “Tobacco-Free Environment” policy that smoking or any tobacco use is strictly prohibited anywhere on the Physicians’ Clinic of Iowa Medical Pavilion campus.
Physicians’ Clinic of Iowa is committed to providing equal opportunity in all areas of volunteering regardless of an individual’s race, religion, age, sex qualified disability or national origin except where these categories are a bona fide occupation qualification.