If you are interested in becoming a Frisbie Memorial Hospital volunteer, please complete this form. Once your application has been reviewed, a staff person will be in touch. Thank you for your interest in volunteering at Frisbie Memorial Hospital.


Contact Information


Availability


Assignment Preference


Interest

Briefly explain your interest in volunteering at Frisbie Memorial Hospital.



Emergency Contact

In the event of an emergency whom should we notify?



Employer

Please list your current or most recent employer, if applicable.



Use of Photographs

On various occasions, we publish photographs of our volunteer on the job for our newsletters and occasional press releases for Frisbie Memorial Hospital. By typing your name in the box below, I/we the undersigned parent(s)/legal guardian(s) of the minor applicant do authorize use of any photos of the minor applicant.



Criminal History

Have you ever been convicted of a felony or misdemeanor or served a period of incarceration within the past seven year? If yes, provide a full explanation.



I Agree

I understand and agree that submitting this application form does not automatically register me as a Frisbie Memorial Hospital 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.