MyImpactPage - Application Form - Central Peninsula Hospital

Organization Policies

I certify that all matters contained in this application are true, and that any misleading or false statements would render this application void and would be sufficient cause for immediate dismissal in the event of placement. I understand that this is an application for volunteering and that no employment contract is being offered. I further understand that as a condition of volunteering I may be required to submit to a drug test according to CPH/HP standards and if my drug test results are unsatisfactory, I will not be placed by CPH/HP.

I hereby authorize CPH/HP to investigate all matters contained in the application and to contact prior employers to obtain any and all information related to my past work performance.

I agree to abide by all Central Peninsula Hospital's and Heritage Place's rules and regulations.

I have read and understand the above.

I am new to MyImpactPage.com

You will need to enter a unique username to identify yourself to the system. You should select something that is easy for you to remember such as your email address or your name. Your username must be at least 6 characters long. If the name you enter is already in use by someone else, you will be prompted to choose another username.

Username

Required

	Username must not start with space
	Username must not end with space
	Username must not have two or more spaces in a row

Email Address

Required

Verify Email Address

Required

I agree with the organization's policies Required

I already have a username

If you have signed up with this organization before, or are a member of another organization that uses MyImpactPage.com, you can use the same login to access all organizations with which you are associated.

Username	Required
Password	Required
Forgot your username or password?
I agree with the organization's policies Required

Already use MyImpactPage.com to volunteer with this organization? Go to volunteer login

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