Volunteer Application: Mount Carmel Clinic

If you need help to complete this form, please phone Volunteer Services:
phone_icon204.589.9418
  • Your Contact Information

  • :
  • Please enter a value less than or equal to 17.
    Note: A Guardian Awareness Form must be completed by applicants 16 years or younger. Phone phone_icon204.589.9418 for this form.
  • Emergency Contact

  • Education

    Formal education is NOT required to be a volunteer. We welcome experience of all kinds.
  • Employment History

  • OrganizationMajor Responsibilities 
    Add a new row
    Click the + (plus) to add another row
  • Volunteer Experience

  • OrganizationMajor Responsibilities 
    Add a new row
    Click the + (plus) to add another row
  • Interests

  • Skills

    Please identify the skills you have and want to SHARE or skills that you want to DEVELOP. Select all that apply.
  • Select all that apply by holding down the Shift or Command key while clicking.
  • (which languages do you want to share or develop)
  • Availability

    Please specify days and hours you are available to volunteer such as 10:00am-3:00pm or 5:00-7:00pm
  • MondayTuesdayWednesdayThursdayFridaySaturday 
    Add a new row
  • References

    Please list 3 current references such as past/present employer, teacher, co-worker, or supervisor from a volunteer experience.