Volunteer Application

  • Emergency Contact Information

  • Emergency Contact Name
  • Emergency Contact Phone
  • Education/Skills/Interests

  • MedStar Harbor Hospital’s purpose is “We make everyone feel special by providing exceptional service every day.”
  • *Information will change due to departmental needs
  • Adult volunteers initial commitment:
    • Minimum of five hours per week for six months for a total of 120 hours
    Junior volunteers initial commitment:
    • During the year: Three hours per week for 10 months for a total of 120 hours
    • Summer: Five hours per week for 12 weeks or a total of 60 hours
  • Reference

    List one reference who is not a relative. Provide the full mailing address for your reference.
  • Name of reference.
  • Address of reference
  • Daytime phone of reference
  • Evening phone of reference
  • I certify that the information contained in this application is accurate. I agree to volunteer a minimum of 120 hours through the year or 60 hours during the summer at MedStar Harbor Hospital.
  • By typing your name in this field you are authorizing your signature.