Volunteer Signup Form
Please note: Unfortunately, we cannot accommodate people attempting to fulfill court-ordered community service requirements.
All fields with asterisk (*) are required.
Emergency Contact Information
Please list someone we can contact in case of an emergency.
(Important to complete for successful placement)
Please provide a personal reference
(not a relative) who has known you for at least one year.
Please check dates and times when you are available
All applicants 18 years and older will undergo a background check.
I agree to comply with all policies and procedures and to support the mission of St. Mary's Medical Center and to serve without remuneration for my services.