Thank you for your interest in volunteering at Mercy Hospital. You may choose to volunteer at our Mercy Campus in Coon Rapids, our Unity Campus in Fridley, or, if you prefer, both sites!

Please complete this application form if you are an individual 18 years or older interested in becoming a Mercy Hospital volunteer. Volunteers are asked to commit to a recurring weekly schedule and commit to a minimum of 50 hours or six months of service. (If you are under 18, please complete the volunTEEN application form also found on this website.) Once you complete the form, please click the continue button at the bottom of the page.

A valid email address is a requirement to using the on-line application process. Please make sure you type the email correctly - as it will be used as a communication tool in the application process. We do not share email addresses with any other party, internal or external.

All items marked with an asterisk (*) are required fields.

Name and Address

First name:

Last name:

Middle name:

Title:

Nickname:

Street 1:

City:

State:

* Zip: *

Home phone:

* OK to call me here

Work phone:

OK to call me here

Cell phone:

OK to call me here

Email address:

How did you learn about our volunteer program?

Campus Preference

Please indicate if you would prefer to volunteer on Mercy Campus in Coon Rapids or Unity Campus in Fridley.

Campus:

Please indicate if you prefer to volunteer on Mercy Campus in Coon Rapids or Unity Campus in Fridley.

Emergency Contact Information

Please provide information for someone that we may contact in case of emergency.

First name:

Last name:

Street 1:

Street 2:

Street 3:

City:

State:

Zip:

Home phone:

Cell phone:

Relationship:

Placement Information

What type of volunteer opportunities would you most enjoy?

* Patient Care Area * Guest Services * Staff Support other

Times

Assignment

Tuesday February 14, 2023:

1:00pm to 2:30pm

Orientation Class [Mercy Campus\A Volunteer Services--MRC]

Saturday February 18, 2023:

9:00am to 10:30am

Orientation Class [Mercy Campus\A Volunteer Services--MRC]

Tuesday March 14, 2023:

1:00pm to 2:30pm

Orientation Class [Mercy Campus\A Volunteer Services--MRC]

5:30pm to 7:00pm

Orientation Class [Mercy Campus\A Volunteer Services--MRC]

Personal Information

Please provide the following information:

Date of birth:

* (year optional)

Gender:

Availability

Please indicate the days and times you prefer to volunteer.

Other Placement Information

Please use this space to tell us about special skills or interests that would be useful for us to know in placing you on our roster.

Volunteer Application Consent

Thank you for taking the time to complete this application for the adult volunteer program at Mercy Hospital, part of Allina Health.

By checking this box you are indicating that the information in this application is accurate and correct to the best of your knowledge.

Failure to fully and truthfully complete this application may result in denial of volunteer service or termination from the service. Mercy Hospital Volunteer Center is not obligated to provide placement, nor are you obligated to accept the position offered. Due to patient safety concerns, Allina is not able to provide opportunities for court ordered volunteer work. We reserve the right to place volunteers in the area we feel is best suited to their skills and the needs of the hospital.

I Agree