Please complete this application form if you are interested in becoming a Northwestern Medicine volunteer. Once you complete the form, click the submit button at the bottom. Someone will contact you within 30 days to discuss opportunities.

Any field with an asterick (*) is a required field.


Name and Address


Other Information


Emergency Contact

Please indicate who we should contact in the event of an emergency.



Availability

FOR APPLICATION TO BE CONSIDERED, please indicate all days and times you are available to volunteer.



REQUIREMENT

To be considered a 6 month commitment is required.




Reference


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 Northwestern Medicine 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.