Please complete this application form if you are interested in becoming a Avista Hospital volunteer. Once you complete the form, click the submit button at the bottom.

Your Contact Information:

Emergency Contact Information

Who shall we contact in case of Emergency?:

Personal Profile Infomation:

Assignment Preference

Please select below your preferences for assignment(s). You can click your mouse on any assignment below to view its description, times, etc.

Your Days/Times Available:

Please indicate the days/times you are usually available to volunteer:

Your Current Situation:

What are you doing now?:

High School Student

College Student

Working Full Time

Working Part Time


Other (please explain)

Previous Volunteer Experience?

Do you have any previous volunteer experience? If so, please explain:

How Did You Hear About Us?:

How did you hear about our volunteer program at Avista?

Why Do You Want To Volunteer At Avista?

Significant Health Problems?

Do you have an significant health problems (either physical or emotional) that should be considered in your placement? If yes, please explain:

Any Felony Convictions?

Have you ever been convicted of any law violation other than a traffic violation? If yes, please explain:

Non-Family References

Please provide 2 non-family references who will say you would be a good volunteer:

I Agree

I understand and agree that submitting this application form does not automatically register me as a Avista Hospital 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.

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