Adult Volunteer Application
We appreciate your interest in UNC Lenoir Health Care and we are sincerely interested in your qualifications to serve our patients and families. The Volunteer Services staff will match your skills and abilities to open positons, and provide orientation and training to prepare you for your volunteer service. In return, we ask for your commitment to serve six (6) months with a minimum of 75 hours. Flexibility is built into the volunteer schedule to help meet the needs of our diverse volunteer team.

Please note that summer students age 15 or older may obtain a Junior Volunteer application in the Volunteer Services office at UNC Lenoir Health Care beginning on April 1. Completed Junior Volunteer applications must be returned by April 30.

Name and Contact Information

Please complete the information requested.

Why Are You Interested In Volunteering?

We are pleased that you are interested in volunteering. Please explain why you want to volunteer at UNC Lenoir Health Care.

Previous Volunteer Experience

Please list the names of organizations that you have volunteered for in the past and describe volunteer duties.

Volunteer Availability

Please indicate the days and times you are usually available to volunteer.

Employer Information

Starting with your MOST RECENT position, list the past two employers or significant work experience.


Please list the name and graduation date of the high school you attended. Then list the highest level of education you achieved. For example, Frontier Central High School - 1971. Bachelor of Science in Nursing, ECU - 1976.


Provide the names, complete mailing addresses, and telephone numbers of two individuals that we may contact as personal references for you. They may not be relatives or personal physicians. In order for your application to be processed, two references must be on file in the Volunteer Services Office.

Emergency Contact

Please list the name and contact information of the person you would like us to call in the event of an emergency.

Criminal Background Information

Please list all criminal convictions with dates of occurrence including misdemeanors.

Application Agreement

Please understand that acceptance as a volunteer is contingent upon satisfactory references, criminal background check, and verification of information submitted on this application. • I agree that UNC Lenoir Health Care may contact any of my above listed references in addition to any employment contacts previous mentioned. Questions on this application are asked for the sole purpose of considering you for volunteer service. We do not discriminate on the basis of race, religion, national origin, age, or handicap status. •I understand that upon my successful completion of the volunteer placement processes required by UNC Lenoir and the approval for service by Volunteer Services Management, I will become a “volunteer”. As a volunteer I acknowledge that I will not receive compensation for service.

Please check the "I agree" box below to give UNC Lenoir Health Care permission to contact the above listed references and previous employers.