Thank you for your interest in volunteering at MidMichigan Health! Please allow yourself approximately 10 minutes to accurately and thoroughly complete this volunteer application. If you have trouble completing this application, please contact the Volunteer Services Department.

**Volunteer Services is not able to offer hours towards clinical experience, job shadowing, internship or court-appointed community service. Please reach out to the Workforce Development office at 989-839-1307 if you are looking for hours for one of these purposes.**

Personal Information

Background Information

Volunteer Information

Emergency Contact Information

Applicant Statement

I acknowledge that the information I have supplied is correct to the best of my knowledge and understand that any deliberate falsifications, misrepresentations or omissions of fact may be grounds for rejection of my application or dismissal from the volunteer program. I understand that consideration for volunteer placement is contingent upon the results of reference, screening for TB and background checks including a criminal check. I therefore authorize MidMichigan Health to invesitgate all statements made on my application and to discuss the results of the investigation with those responsible for volunteer selection and placement. If accepted for volunteer placement, I will comply with the values, policies and procedures of MidMichigan Health in effect or revisions which may be issued in the future. Misrepresentation of facts constitutes cause for separation from volunteer placement. I understand that the position that I am applying for is an unpaid volunteer position.