Please complete this application form if you are interested in becoming a His Hands Free Clinic volunteer. Once you complete the form, click the submit button at the bottom.
Please list your current or most recent employer, if applicable.
You may optionally provide the following information. This is used only to help us recognize the diversity/demographic make-up of our volunteers.
The following volunteer assignments may currently be available. Click the assignments to rank your top three choices.
In the event of an emergency, whom should we notify?
Please indicate the days and times you are usually available to volunteer.
***This section to be completed by medical, dental, and chiropractic volunteers ONLY
If applying for a professional position (ie: doctor, nurse, dentist, ARNP, CMA, etc.), or prayer support, please list two references, other than family members. By providing names, you consent to His Hands Free Clinic staff contacting your references regarding your volunteer application.