Physician Referral 847.535.6171Main Telephone 847.234.5600patient scheduling 847.535.8000nmh.org
About Us

Student Volunteer Application

Upon receipt of this application, we will schedule a 20-minute interview to explore if your interest and schedule meet the current needs for volunteers at our Lake Forest Hospital and Grayslake campuses, or other facilities.

You may be asked to submit to a free TB test before you begin volunteering. If you were born after 1957, we will need your immunization records (measles, mumps, rubella and chicken pox).

Thank you for your interest in volunteering at Lake Forest Hospital.

Please note that all questions are required. If the question doesn't apply to you, please enter "n/a".
First Name / MI
Last Name
Date of Birth
Gender Male Female
Telephone
Email
Address
City / State / Zip
Parent Name
Parent Telephone
School Name
Year of Graduation

Why would you like to volunteer at Lake Forest Hospital?

How did you hear about our Student Volunteer Program?

Are you meeting a requirement by volunteering? 
Yes No
If so, what for?

What are your interests or skills (art, music, computers)?

What types of volunteer activities would you like to do at Lake Forest Hospital?

Will you be able to volunteer four (4) hours a week for a minimum of twelve (12) consecutive weeks during the school year or eight (8) consecutive weeks during the summer?

Yes No

When would you like to volunteer?
(Please check all that apply.)
Monday Morning
Tuesday Afternoon
Wednesday Evening
Thursday All Year
Friday School Year
Saturday Summer Only
Sunday  

Please list any dates that you may leave town for an extended period of time.

When would you like to begin volunteering?
Click Here to Pick the date

Please list your other volunteer activities. 

Have you ever been convicted of a criminal offense?

Yes No

Please list the name of a reference, their relationship to you and a telephone number.
Reference Name
Relationship
Telephone
I agree to interview with Volunteer Services and to attend a new volunteers' orientation.
I agree to provide TB test results or submit to a free TB test through Lake Forest Hospital and to provide immunization records, if required.
I agree to comply with hospital procedures and policies as outlined in the Volunteer’s Handbook.
I have secured my parent’s permission to participate in the Lake Forest Hospital Student Volunteer Program.
I certify that the information I have given here is correct to the best of my knowledge.
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