Thank you for your interest in volunteer services at Norton Women’s & Children’s Hospital. Please complete this application, as it will be reviewed for consideration.

Once you complete the form, click the submit button at the bottom. By submitting this form you are giving Norton Healthcare permission to perform a criminal background check.

Contact Information and References

I authorize the release of information to be sent to my references listed on my application. Please enter two references listed below numbered 1 and 2.

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.

Skills and Experience

Please list your skills and any physical limitations.


Please indicate the day(s) and time(s) you are available to volunteer.

Assignment Preference

The following volunteer assignments may currently be available. Use this list to rank your top three assignment choices.

Emergency Contact

In the event of an emergency whom should we notify?


Please list your current or most recent employer, if applicable.

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.

I Agree

I understand and agree that submitting this application form does not automatically register me as a Norton Healthcare volunteer, and that there may be certain qualifications I must meet, including the acceptance of established volunteer policies and procedures before I may begin volunteering. Submission of this application affirms that I give permission for a criminal background check if I am 18 or older.

By submitting this form, I attest that the information I have provided on the form is true and accurate.