Camp Circle of Love Volunteer Application - Chapters Health System

Background Screening/Fingerprinting
As of August 1, 2010 we have had new regulations which now require us to obtain fingerprints for all
employees and volunteers who provide direct support to clients.
Fingerprints will be completed at no cost to you. However, you will be required to have your
fingerprints done before we are able to assign you to a camp volunteer role. Once we receive and
process your Camp Circle of Love volunteer application, we will be in contact with you to get your
fingerprint screening completed or, if you have previously been fingerprinted with us, we will confirm
whether we will need for you to be re-fingerprinted. Most of our returning volunteers that have not
remained an active LifePath Hospice patient-family volunteer or staff member will need to be refingerprinted.
We are also required to have you submit a signed affidavit (see attached form) which we will maintain
in your volunteer file in our Human Resource Department. Please complete this form and submit it
with your Volunteer Application.
Thank you in advance for your willingness to complete the necessary screening requirements to
volunteer with us. If you should have questions regarding this process, please contact Scott Cornelius
at 813-357-5603.
Please sign and date both the affidavit & privacy acknowledgement and return it with your
completed application.
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