Please complete this application form if you are interested in becoming a Grant Medical Center volunteer.
The Volunteer Office is closed because of Covid 19 and I am on a Leave of Absence. However, I will be checking for applications and emails from time to time. So if you apply, I will reach out to you. So please go ahead and apply!
Items marked with an asterisk (*) are required for application to the program.
Once you complete the form, click the green continue button at the bottom of the page.
Volunteer Coordinator

Name and Address

Currently, Grant Medical Center is accepting applications from those 18 years of age and older.

Emergency Contact Information

Please enter information for the person you would like us to contact in the event of an emergency.
You must provide at least one contact phone number.
This should be the best number to reach your emergency contact if there is an emergency.

Personal & Professional References

Please list two complete references.

Demographic Information

Social Security Numbers, present & two past residential addresses are collected in order to conduct background checks, which are required to volunteer.


Have you ever been convicted of any crime other than a minor traffic violation? Please indicate any convictions below. Having a conviction record will not necessarily bar you from volunteering. A background screening will be used to determine eligibility.


Please indicate the days/times of week you expect to be available to volunteer.

Email Preferences

We like to keep volunteers informed of important news, schedules, and volunteer opportunities by email, however we 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.


Please provide information about your current employer.

Terms of Application

The information submitted in this application is accurate and correct to the best of my knowledge. By checking the box below, you have indicated your approval for us to check references, conduct a background check and contact your physician regarding your physical and emotional health. The organization is not obligated to provide a placement, nor are you obligated to accept the position offered. You acknowledge that you are volunteering by your own choice and that Grant Medical Center shall not be liable for any injury or harm sustained by you or any claim made by you pursuant to your role as a volunteer. You also agree to have a T. B. Skin Test prior to your first day as a volunteer and once per calendar year thereafter.