Become a Volunteer

Thank you for your interest in seeking volunteer opportunities with OSF St. Mary Medical Center.

To become a member of our volunteer team, simply complete the application below.

* indicates a required field.

* First Name:
M.I.:
* Last Name:
* Street Address:
* City:
* State:	Two (2) Letter Abbreviations Only.
* ZIP:	Five (5) Digits Only.
* Phone:
Email:
Birth Month:
Birth Day:
Employment Information
* Are you currently a student?:
If yes, where and anticipated graduation date?:
* Employment Status:
Current Employer:
How Long Have You Worked There?:
Contact Name:	Please provide the name of someone at work we may contact.
Contact Phone:	Please provide the best number to reach your employer contact at.
Criminal History
* Other than minor traffic violations, have you ever pled guilty to or been convicted of any criminal offense?:
Explanation:	If you answered "yes" to the previous question, please explain here.
References Please provide the name, address, and phone number of three (3) non-family references below.
* Name (1):
* Address (1):
* Phone (1):
* Name (2):
* Address (2):
* Phone (2):
* Name (3):
* Address (3):
* Phone (3):
Volunteer Information
* What positions are you interested in?:	Clerical Assistance Courier Gift Shop Information Desk OSF MyChart Patient Escort Surgery Waiting Area
* What days can you volunteer?:	Monday Tuesday Wednesday Thursday Friday Saturday Sunday
* Shift Preference:	Mornings Afternoons Evenings

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Employment Information