Thank you for your interest in volunteering with the St. Lawrence Health.

Personal Information

Emergency Contact

Employment Information

Volunteer Experience

Please list any previous volunteer experiences:

Volunteer Services Commitment

A typical commitment is one 2-hour shift per week, on a regular schedule. Please list any schedule preferences you have:

Volunteer Assignment

Please indicate your preference(s) for the following volunteer assignment areas:
1) Gift Shop
2) Non-Clinical, Clerical Department Support
3) Patient/Family Support (Patient Care areas)

Hospital Selection

Please indicate if you want to volunteer at Canton-Potsdam, Gouverneur, or Massena Hospital.

Adult Volunteer Applicant Agreement

I understand in order to participate as a Volunteer, I must read and sign confidentiality statements, successfully complete a criminal investigation, drug screening, meet all physical requirements, and successfully complete orientation and training.

I understand that a minimum commitment of one two-hour shift per week for at least eight weeks is required.