Good Shepherd Ministries Administration
Thank you for your interest in volunteering at Good Shepherd Clinic! Good Shepherd Clinic thrives on the kindness and generosity of our volunteers. Start with prayer, and then take these next three steps to join the ministry.
1. Complete the appropriate form, click the submit button at the bottom.
2. After your application has been submitted, you will receive a confirmation e-mail with a link to the waiver and liability forms. Please bring these completed forms, along with any pertinent license (physicians, dentists, hygienists, nurses, administrative, DEA registration, etc) to the clinic.
3. Once you have completed the volunteer packet , your coordinator will work with you providing orientation and details about your assignment. Thanks again!!
Name and address
First name:
*
Last name:
*
Title:
Choose
Dr.
Mr.
Mrs.
Ms.
*
Street 1:
*
Street 2:
Street 3:
City:
*
State:
Choose
OK
*
Zip:
*
Home phone:
OK to call me here
Cell phone:
OK to call me here
Email address:
*
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.
Date of birth:
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
1919
1918
1917
*
Gender:
Choose
Female
Male
*
Church:
Lifechurch member:
Emergency Contact
First name:
*
Last name:
*
Home phone:
*
Relationship:
Choose
Co-worker
Daughter
Father
Friend
Mother
Neighbor
Son
Spouse
Supervisor
*
Availability
Please indicate the days and times you are usually available to volunteer.
Mon
Tue
Wed
Thu
Fri
Morning:
Afternoon:
Evening:
*
Administration Classification:
Data Entry
Other
Spiritual Counseling
Translator
Email Preferences
Please use non-student e-mail address.
Use the checkboxes below to select the kinds of email you would like to receive from us.
*Please note that opting out of "Volunteer Opportunities" prevents Good Shepherd Ministries from sending your volunteer information to get started volunteering.
What kinds of email would you like to receive?
Volunteer Opportunities
*Includes Volunteer Login Information
Electronic Newsletters
Schedule reminders
Photo/Video Release
I authorize Good Shepherd Ministries, Inc. to use any photographs, images,or videos of me for a variety of purposes in any type of print, video, or digital media, including internet sites, without restriction. I agree that these images may be used without further notifying me. I understand that I will not be paid or rewarded for providing this authorization.
I Agree
Continue