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Adult Volunteer Application

Thank you for your interest in serving as a volunteer at St. Mary’s Medical Center and Palm Beach Children’s Hospital. We are currently recruiting volunteers who can meet our minimum commitment of four hours per week for at least a six month period. If you are a student or seasonal resident seeking a volunteer opportunity for less than six months, please explain your availability in detail on the enclosed application.  Please give this serious thought before you commit; our patients and staff count on volunteers. 

Complete Application for Adults (applicants 18 years and older)

Application Information

All fields with asterisk (*) are required.

Enter your date of birth in this format: mm/dd/yyyy

Have you ever worked at St. Mary's Medical Center?
Do you have any physical limitations, medical limitations, or mental disorders that would impair your ability to perform as a volunteer at St. Mary’s Medical Center without any supplemental assistance?
Have you ever been convicted of a crime? (an affirmative response will not automatically disqualify you from being considered)

Emergency Contact Information

Please list someone we can contact in case of an emergency.

Name of Friends or Relatives Employed or Volunteering at St. Mary’s Medical Center

Personal References

Please list three personal references (Employers, Volunteer Supervisor, Teacher, etc. – No Relatives)

Short Response

1. What is your previous volunteer experience? For each experience, please include the following information.

4. What special skills, interests or strengths would you offer as a volunteer? Please note if any of the following categories are applicable and elaborate.

9. Volunteer interest in: 

Education and Work Experience

Please include university attended, area of study and degree obtained

Please include university attended, area of study and degree obtained

Please check the answers that apply to you
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.

Please enter date in this format: mm/dd/yyyy

Additional Requirements

Volunteer Background Information

If you want to make a real difference in the lives of others, you can be a volunteer at Palm Beach Children's Hospital.
Volunteer Disclosure & Authorization

If you want to make a real difference in the lives of others, you can be a volunteer at Palm Beach Children's Hospital.