Thank you for your interest in volunteering at United Hospital. Please complete this application form if you are a student between the ages of 15 and 18. Once completed, select CONTINUE button at the bottom of this page.


" You will need a parent or guardian available to approve this application on-line.

" 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 with a asterisk (*) are required fields.


Please note; your volunteer application and any submitted health documents will be retained for 30 days. Please be sure to complete the steps below within 30 days to ensure you don’t have to reapply and resubmit forms.


Name and address


Demographic Information

Please provide the following information. It is used only to help us get a better idea of the demographic make-up of our volunteers.



Immunization Information

Evidence of immunity is a requirement for volunteering at United Hospital. Once your application is received an email will be sent with information on how to begin the health clearance process.



Email Preferences

We like to keep volunteers informed of important news, schedules, and volunteer opportunities by email, however will not send you any email you prefer not to receive. Use the checkboxes below to select the kinds of email you would like to receive from us.


The "Application follow up" and "Volunteer Center Communication" must be checked or you will miss required information regarding next steps in the volunteer placement process. All this informatin is communicated by email.



Emergency Contact Information


Availability Information

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



Parent/Guardian Consent

Thank you for taking the time to complete this application.


By checking this box, you are indicating your approval for your child's participation in the junior volunteer program. 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. You are agreeing to provide United Hospital with a minimum of 60 volunteer service hours within a 6 month period. United Hospital Volunteer Center is not obligated to provide placement, nor are you obligated to accept the position offered. We reserve the right to place volunteers in the area we feel is best suited to their skills and the needs of the hospital.