Please complete this application form if you are interested in becoming a Courage Kenny Rehabilitation Institute volunteer in our Northland location (Duluth/Twin Ports). A valid email address is required to complete this application and will be used as a communication tool in the application process. Email addresses are kept confidential and are not shared. All items with an asterisk(*) are required fields. Once you complete the form, click the continue button at the bottom.


Thank you!


Please note if you are under 18, your parent/guardian will need to sign at the bottom of this application. You must be 16 years of age to volunteer.


CONTACT INFORMATION

*If you only use your cell phone, please put that number in the home phone field as well.



DEMOGRAPHIC INFORMATION

This information is used in aggregate data for demographic purposes only.



EMERGENCY CONTACT


PLEASE COMPLETE THE FOLLOWING REQUIRED QUESTIONS:


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INTERESTS AND AVAILABILITY

Volunteers are asked to make a minimum commitment of 2 months or for the full duration of their selected programs, programs typically run for 8 weeks. Please indicate the days and times you are usually available to volunteer.


Please click on the Assignment Preference hyperlink to see more information about each volunteer position.



SIGNATURE

As part of our Commitment to Care, Allina Health has recently announced required influenza and COVID vaccine policies as added safety measures for our communities. 

Allina Health will begin requiring COVID-19 vaccination by Oct.1, 2021 for all employees, volunteers, students and contracted staff, with limited exemptions for medical or religious reasons. By January 1,2022 all employees, volunteers, students and contracted staff must receive the influenza vaccination with limited exemptions. Your volunteer coordinator will provide more information on how to document vaccine verification or apply for an exemption. 


Failure to fully and truthfully complete this application may result in denial of volunteer opportunity or termination from the service. Courage Kenny is not obligated to provide placement, more are you obligated to accept the position offered.


Please type your name below to verify you agree with these statements and all of the information provided is accurate.


If you are a minor, please have your parent/guardian sign as well.