Volunteer Application

Thank you for your interest in becoming a volunteer at OSF St. Francis Hospital & Medical Group.

Please fill out the following form and our volunteer coordinator will be in contact with you shortly.

Prefer to use mail or fax? Download the PDF application.

This form is for OSF St. Francis Hospital in Escanaba, Michigan only. For questions about OSF Saint Francis Medical Center in Peoria, Illinois, please visit www.osfsaintfrancis.org.

* = Required

Last Name *

First Name *

Street Address *

City *

State *

ZIP *

Phone *

Age *

18 or Over
Under 18

Emergency Contact

In case of an emergency, please let us know who we should contact on your behalf.

Name *

Phone *

Experience

Previous Volunteer Experience

Skills, Language(s), Hobbies, Special Interests

Clubs & Community Affiliations

Medical Information

Personal Physician

References

Please provide one (1) personal and one (1) professional character reference below.

Name (Personal) *

Address (Personal)

Phone (Personal) *

Name (Professional) *

Address (Professional)

Phone (Professional) *

Other Information

Other than minor traffic violations, have you ever pled guilty to or been convicted of a criminal offense? *

Yes (Please Explain Below)
No

Explanation
If you answered yes to the previous question, please use this field to explain.

Reasons for Volunteering at OSF St. Francis Hospital

The Sisters of the Third Order of St. Francis

3401 Ludington Street • Escanaba, Michigan 49829 • 906.786.5707