Ascension Via Christi Hospital in Manhattan Volunteer Application Form
Please complete this application form if you are interested in becoming a volunteer at Ascension Via Christi Hospital in Manhattan.

Once you complete the form, click the submit button at the bottom.

Not all positions are available if you are under 18 years of age.

Personal Information

Emergency Contact


Please supply three adult references, not relatives, you have known for at least two years; employer, minister, counselor, etc.


I am willing to complete a background check and provide documentation of:
• 2 MMR vaccines and/or positive titer
• 2 Varicella vaccines and/or positive titer
• Tdap vaccine at age 11 or later
• Flu Shot (current flu season documentation required between 10/1 and 3/30)