Please complete this application form if you are interested in becoming a Debbie-Rand Memorial Service League, Inc. teenage volunteer (TAV). Once you complete the form, click the submit button at the bottom.

Name and Address

Legal Guardian Name and Contact Information

Please list any school activities, sports, etc.


You must be at least 15 years of age.


Volunteers work one (1) four hour shift per week. Please indicate the days and times you are available to volunteer.

Volunteer assignments will be given to TAVs at the orientation. The assignment given will be based on the needs of the hospital and the TAV’s availability.

TAVs are not allowed to work in the Nursery or Emergency Room, or in departments in which a parent or relative works.

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.


Please state the reason that you would like to become a volunteer.

Date available to start volunteering:

Emergency Contact Information


The Debbie-Rand Memorial Service League has a clear set of policies and procedures which provide for good order and assures the highest standards in patient care and services. By checking "I agree", you indicate that you understand and will comply with the following conditions.

-I understand I am scheduled for a regular assignment and that being reliable is very important. I understand that I am only allowed four excused absences during my six-month commitment. For an absence to be excused, I must give advanced written notice or verbal notice to the volunteer office. Two unexcused absences will result in immediate dismissal from the program. After that, D-RMSL WILL NOT verify my volunteer service hours.

-I understand that letters verifying hours are given upon advance request, provided that I have completed six months of service and that I am in good standing. In order to receive verification of hours, I must have completed six months of volunteer service with D-RMSL, prior to leaving the program. Also, in order to be in good standing, I must give the volunteer office notice of my decision to leave the program prior to leaving.

-I understand that D-RMSL will determine all assignments given to me.

-I understand that if I have a “slow period” I may secure approval to do homework or read. I am not permitted to use cell phones, handheld electronics (“game boys”, MP3 players, PDAs, etc.) or to use the hospital phone, computer or other equipment for any thing other than hospital business. I am also not permitted to be in any other area other than which I am assigned.

-I understand that I am required to present a professional and positive image at all times while in uniform or on hospital property. Moreover, my behavior must be respectful and appropriate for a hospital.

-I understand that I am required to wear a proper, clean and pressed D-RMSL uniform jacket, white or khaki, regular-cut, ankle length slacks with sneakers or closed heel and toe shoes. Any shirt worn under the jacket that is visible must be white. Jackets are to be worn buttoned or zipped up. No cargo pants, capris or oversized slacks are allowed. Females may not wear more than two earrings in each ear. Make up and jewelry are to be kept to a minimum. Males may wear one earring and minimal jewelry; no makeup. Hair must be neatly styled and worn off the face. I understand that I will not be allowed to volunteer if I am not in proper uniform.

-I understand that I must arrive on time to the orientation . Failure to do so may result in me not being allowed to attend the scheduled orientation. I will then have to wait until the next class.

-I understand that I must bring a parent or guardian with me to the orientation.

-I understand that I must stay for the duration of the orientation. The orientation normally lasts for approximately 1-2 hours.

-I understand that I must turn in the completed application packet at least one week prior to orientation.

Both my parent and I have read and agree with the above regulations. Failure to comply with the aforementioned rules will result in dismissal from the program and/or denied entry into the program.