Please complete this application form if you are under the age of 17 and interested in becoming a Lake Region Healthcare Junior Volunteer. (All Junior Volunteers must be currently in 7th grade or beyond to participate.) Once you complete the form, click the submit button at the bottom.
Please include your parent's name and phone best to be reached at here:
Please explain your hobbies, skills and special interests.
For summer scheduling purposes, please list any schedule conflicts (band lessons, church camp, etc.)
Please explain any any work activities or conditions you must avoid.
Please list 1 teacher, pastor, or other role model whom we may contact for a personal reference.