Volunteer

Volunteer Driven

The Rural Parish Clinic—Medical and Dental—are both volunteer-driven… literally! We need volunteers with different skill sets and interests: drivers, donors, doctors, nurses, dentists, hygienists, and people to welcome clients. Apply below to join our volunteers.

We also invite volunteers to join our Spiritual Apostolate, to commit to prayer for our ministry.

Join our Spiritual Apostolate

Access Volunteer Resources

Apply

We are grateful you have chosen to volunteer with the Rural Parish Clinic of the Archdiocese of St. Louis (RPC). We welcome you to participate with us in the healing ministry of Jesus Christ. Please complete the following application in full.

Please note your information is private and will not be shared outside of this organization.

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Personal Information – Step 1 of 3

Applicant's Name *

First

Last

Have you used any other names in the past? *

If yes, please list:

Applicant's Address *

Address Line 1

Address Line 2

City

State

Zip Code

Applicant's Email Address *

Applicant's Phone Number *

Applicant's Birthdate *

Emergency Contact Information

Emergency Contact Name *

First

Last

The family member/friend contact information provided will be used in the event of a medical emergency for a volunteer.

Emergency Contact Phone *

When are you available to start volunteering? *

What tasks would you most enjoy and prefer? I would like to volunteer as…. *

Doctor
Nurse
Dentist
Hygienist
Dental Assistant
Receptionist
Drive
Office administrative worker
Special projects volunteer
Clinic preparation and cleaning worker
Scanner of medical documents
Development worker
Case manager
Other (see below)

Other volunteer preference:

Have you ever been discharged or requested to resign from any position? *

If yes, please explain:

Have you ever been convicted of/pleaded guilty to a misdemeanor/felony? *

If yes, please state the nature of the offense for which you were convicted or pleaded guilty, date of conviction or entering of plea, judgment imposed, the court imposing judgment and its location, and docket number of proceeding:

A yes response to either of the two preceding questions will not disqualify you from consideration. A record of conviction, or a refusal by a surety company to issue or continue a bond on your behalf, does not mean that you cannot volunteer. The nature and circumstances of any conviction or bond refusal, how long ago either occurred, or other factors, including the relationship of the conviction or bond refusal to the position for which you are seeking to volunteer, are all important in the volunteerism consideration. Thus, please provide a complete response to these questions so that an appropriate decision can be made. In connection with your application to volunteer and at any time during your volunteering, if selected, you may be required to submit to the Rural Parish Clinic of the Archdiocese of St. Louis a copy of any and all records regarding your convictions that have been maintained by either the police or sheriff departments. If you have not been convicted of or pleaded guilty to a misdemeanor or a felony, you may be required to submit written confirmation of that signed by an authorized official of the police and sheriff departments listed above.

If the following section does not apply, please mark each question or leave blank and proceed.

Have you at any time been accused of child abuse? *

(You are required to answer this inquiry whether or not a criminal conviction arose out of the allegation.) If yes, complete the following: Provide in detail the date, place, and an account of the circumstances surrounding each allegation of abuse:

Date of Alleged Abuse

Address of Alleged Abuse

Address Line 1

Address Line 2

City

State

Zip Code

Circumstances of Alleged Abuse

Did any administrative or judicial proceedings arise out of the allegations?

If yes, please identify the agency or court in which the proceeding was brought and its location, the parties to that proceeding, the docket number of the proceeding, and any judgment or resolution that was entered or reached:

Are you under the supervision of any federal, state, or local agency as a result of any allegations of child abuse?

A yes response to any of the three preceding questions will not necessarily disqualify you from consideration for employment. The nature and circumstances of the matters reported as well as their disposition are all important factors in consideration.

Are you currently employed? *

Are you currently volunteering? *

Name of most recent employer or volunteer organization: *

Position held *

Supervisor's name *

Supervisor's phone

Supervisor's email *

Describe primary duties, particularly those you most enjoyed.

Skills and Affiliations

Describe any training or apprenticeships, professional or social affiliations, or any specialized skills that you possess that may be pertinent and valuable to the RPC.

Education

Undergraduate University

Undergraduate Graduation Date:

Graduate University

Graduate School Graduation Date

All volunteers and employees of the Archdiocese of St. Louis are required to complete Safe Environment trainings within the Prevent and Protect program. Two trainings, Code of Conduct and Mandated Reporter, are online, available 24/7, to be completed at your convenience. The final training, Protecting God’s Children (PGC), must be completed as a live class, either via Zoom or as an in-person training offered at a parish site or other location. Registration information for these trainings and upcoming classes can be found at: https://www.preventandprotectstl.org/s/stlouis/pgc.htm *

I agree to complete Safe Environment Training.

Signature *

I attest by signature above that all portions of this application have been completed thoroughly and accurately to the best of my knowledge. I grant permission to the Rural Parish Clinic (RPC) to verify all information.

Today's Date *