There are two forms to complete for the Junior Volunteer Program:

1) This electronic application form must be completed if you are interested in becoming a OSF HealthCare volunteer. Once you complete the form, click the "Continue" button at the bottom.

2) Return to the Volunteer web page and click on the Junior Reference Form (PDF). Print the form out and complete. Send that form to address listed at the bottom.


Name and Address


Education

Which best describes your school experiences. Check all that apply:



College Major/Career Interest

Tell us about your College Major/Career Interest and when you graduate or anticipated graduation date in the box below.



Volunteer/Work Experience/Skills/Interests

Please indicate any skills, languages, hobbies, special interests.



School, Church or Community Activities


Why do you want to volunteer?

Hospitals exist to improve or maintain patients' health, so anything you do to help the hospital is, directly or indirectly, making people healthier and improving their lives.



How did you hear about OSF HealthCare?


Volunteer Availablility

Volunteer shifts are 3 – 4 hours scheduled according to the department need. Volunteers are asked to make a minimum commitment of one shift per week for 1 year. Please check your availability: Mornings:7:30am-12pm; Afternoons:12pm-4pm; Evenings:4pm-7pm



When finished with this application...

Select "Continue" at the bottom of this form **or** print it out and send your completed application to:

OSF HealthCare Volunteer Services

5666 E. State Street

Rockford, IL. 61108

Fax: (815) 227-2592

Phone: (815) 395-5064



CAREFULLY READ THIS SECTION:

By checking the "I Agree" box and selecting the "Continue" button 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 hiring process may disqualify me from further consideration for a volunteer position and may result in discharge even if discovered a later date.

I understand that OSF HealthCare is not obligated to provide placement, nor are you obligated to accept a position if one is offered. Opportunities for volunteers are provided without regard to religion, creed, race, national origin, age, or sex.