Faith in Action Volunteer Application

We always look forward to hearing from new volunteers!

Apply online by completing the online form below.

* indicates a required field.

Basic Information
* Name :
* Address:
Address 2:	Please indicate if there is an apartment or suite number
* City:
* State:
* ZIP code:
* Email :
Cell Phone:
Home Phone:
* Date of Birth:	dd/mm/yyyy
Are you a veteran:
Preferred Areas of Ministry
* Please select the areas in which you wish to volunteer:	Errands Exercise Class Home Visits Long Distance Office Phone Visits Public Speaking SHIP/Medicare Assistance Social Events Special Projects Temporary Relief for Caregivers Transportation-Local Transportation-Long Distance You may make more than one selection.
Willing to Assist
* Please select how often you would be willing to assist:
Times Available
* Please select the days of the week when you are available:	Monday Tuesday Wednesday Thursday Friday Saturday Sunday You may make more than one selection.
* Please select the time of day when you're available:	Morning Afternoon Evening You may make more than one selection.
Information to Match a Care Receiver
* What is your current occupation:
* Do you have previous volunteer experience? If so, please describe:
* What are your hobbies or interests :
* Are you a smoker:
* I am willing to visit a smoker:
Emergency Contact
* Emergency Contact Name :
* Contact Phone :
Relationship:
Volunteer Health
* Do you have any physical condition that may limit your activities:
If yes, please describe:
Volunteer Driver
* Do you have a driver's license:
* Do you have auto insurance:
* Have you ever been convicted for violation of any laws, traffic or otherwise:
If yes, please explain:
* What type of vehicle do you own:	Car Multiple Vehicles Truck Van
References Please provide Faith in Action with the names of two different people who are not related to you, have known you for at least a year, and who can serve as references.
* Reference #1 Name:
* Reference #1 Phone:
Reference #1 Email:	If email address isn't known, please use mailing address field below
Reference #1 Mailing Address:
* Reference #2 Name:
* Reference #2 Phone:
Reference #2 Email:	If email address isn't known, please use mailing address field below
Reference #2 Mailing Address:
Consent By signing my name below I consent that Faith in Action/OSF may contact the references I have listed, the information I have provided, to the best of my knowledge, is correct, and my information will be entered into an online encrypted database and used to contact me regarding Faith in Action/OSF volunteer opportunities and/or information deemed important for the hospital and ministry.
*	Yes

Don't Want to Apply Online?

You may also download and print an application

Download Application

You may email your finished application to shmc.fia@osfhealthcare.org

You may also mail your application to the address below:

Faith in Action

Care of OSF HealthCare Sacred Heart Medical Center

812 N. Logan Avenue, Danville, Illinois 61832

For More Information

Please contact us at (217) 431-8489, or email us at shmc.fia@osfhealthcare.org

We respect and safeguard your privacy. This form is secure.

Faith in Action Volunteer Application

We always look forward to hearing from new volunteers!

Basic Information

Preferred Areas of Ministry

Willing to Assist

Times Available

Information to Match a Care Receiver

Emergency Contact

Volunteer Health

Volunteer Driver

References

Consent

Don't Want to Apply Online?

For More Information