Please complete this application if you are interested in serving with Friends of Memorial. Once you complete the form, click the submit button at the bottom.


Personal Information


Demographic

You may optionally provide demographic information. Demographic information is used only to help us have a better understanding of the make-up of our volunteer team.



Volunteer Experience


Education


Employment


Interests and Availability


Retired and Senior Volunteer Program (RSVP)

If you are part of the Retired and Senior Volunteer Program through Senior Corp, please complete this section. We will automatically send your hours and mileage for volunteering at Memorial to RSVP. RSVP is a separate program from Memorial. To learn more, please contact RSVP at (217)528-4035.



PLEASE REVIEW PRIOR TO PROVIDING AGREEMENT BELOW

I hereby affirm that the information on this application is true and complete. I understand that any false or misleading representations or omissions made on the application or during the orientation process may disqualify me from further consideration for a volunteer position and may result in discharge even if discovered at a later date.


I understand that Memorial Medical Center is not obligated to provide placement, nor are you obligated to accept a position, if one is offered. As a volunteer, I understand that my services are rendered on a gratuitous basis.


If completing this application as a hard copy, please sign the application as well.