Application for Volunteer Services

A conviction will not necessarily disqualify you from being selected as a volunteer.



Personal Reference:

References: (please give complete names & addresses)

Volunteer or paid experience:

Please read and check yes or no below:

I acknowledge that I am volunteering my services to Noyes Memorial Hospital freely for motives of charity or community service. I do not expect to be paid or receive a benefit of any kind in return for my volunteer services. I understand that if I am selected as a volunteer, my ability to participate is subject to completion of appropriate lab work, blood pressure check, PPD, and background check.

It is the policy of Noyes Memorial Hospital to provide courtesy parking and lunch or dinner.