Please complete this application form if you are interested in volunteering. Once you complete the form, click the submit button at the bottom.

Applicant Information

Demographic Information

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

Emergency Contact

In the event of an emergency whom should we notify?


Please complete all of the following which best describes your education.

Work/Volunteer Experience

Please provide the name and address of your current or most recent employer if applicable.

Alternate Address

Use this section to list any alternate/permanent addresses you have that are different than the one you listed as your current address.


Please provide the name of an additional individual (not a relative) who may be contacted for a personal/professional reference.

How did you hear about our volunteer program?

I agree

Thank you for taking the time to complete this application and for providing all the information that was requested.

By checking this box you are indicating that the information in this application is accurate and correct to the best of your knowledge. I understand that volunteers will serve at will. North Memorial Health, solely at its discretion, shall determine who shall serve as a volunteer and may dismiss a volunteer at any time with or without cause.

I also understand that this is not an application for paid employment.

Volunteer opportunities are provided without regard to religion, creed, race, national origin, age or sex.