Please complete this application form if you are interested in becoming a Winnipeg Regional Health Authority volunteer. This application form is specifically for community health and corporate programs as well as the Breast Health Centre and Pan Am Clinic.

Once you complete the application, please click the submit button at the end of the form. This will automatically forward your application to the WRHA Volunteer Services Office.

Contact Information

Please remember to include your area code with your phone number.


Formal education is not required to be a volunteer. We welcome experience of all kinds!

Employment History

Please indicate the organizations that you are currently working for or have been employed by in the past.

Previous Volunteer Experience

Please indicate the organizations that you currently are volunteering for or have volunteered for in the past including: community clubs, schools, religious organizations, professional associations, non-profit organizations, sporting organizations, etc.

How did you find out about our program?

Please check the reason(s) you found out about the program.

Main Reason for Volunteering

Please check the reason(s) you would like to volunteer.

Skills and Experience

Please check the skills and experience you have to offer.


Please indicate the days and times you are usually available to volunteer. We typically do not offer volunteer opportunities during evenings and weekends.

Community Area/Location Preference

Please check the area where you'd like to volunteer.

Is there a specific role you are interested in?

Please indicate.

Emergency Contact

Who would you like for us to contact in case of emergency?


If you wish to have anything further to be taken into consideration when determining a volunteer placement (for example: mobility issues, back problems or allergies), you may list those issues in the space provided.

References and Disclaimer

If you are interviewed as a potential volunteer, you will be asked to provide three (3) references. Please note references from family members or from personal friends will not be accepted, unless you were employed by them.

By submitting this application, I agree that the information I have provided on the form is true and accurate. Furthermore, I understand and agree that submitting this application form does not automatically register me as a volunteer. It is the policy of WRHA Volunteer Services to screen all prospective volunteers. While we try to place every prospective volunteer, management reserves the right to decline applicants who do not meet our requirements and/or placement criteria. I consent to this information and information about my volunteer work with WRHA to be maintained on the Volgistics website and absolve and release the WRHA from all and any liability that may otherwise accrue by reason of keeping this information on the Volgistics website and using this information for WRHA purposes.