Ascension Volunteer Application

Thank you for your interest in volunteering with us!

We look forward to matching your skills and interests to our opportunities. To apply, please complete the application form below and click on the submit button at the bottom.

New User Details

User ID

User ID (verify)

Password

Password (verify)

Location

Which hospital are you applying to volunteer at?

Indianapolis Volunteer Program

Please indicate where you are most interested in volunteering.

(check all that apply)

Main Hospital 86th St.

Women's Hospital (NICU is currently FULL)

Peyton Manning Children's Hospital

Pet Therapy

Personal Information

* First Name

* Last Name

* Home Address

* City

* State

* Zip Code

* Mobile Phone

Home Phone

* E-mail Address

* DOB

Gender

Employment Status

Please select any additional language(s) that you speak.

Wheelchair/requires handicap access

Do you have any medical conditions we should be made aware of? If so, please explain.

Emergency Contact Information

* Contact name

* Relationship to applicant

Address

City

State

Zip Code

* Cell Phone

Home Phone

E-mail

Criminal Background History

Have you ever been convicted of or plead guilty or no contest to a felony, misdemeanor, or any offense other than a minor traffic violation?

* Please explain:

Are any criminal charges now pending against you that are not yet resolved?

* Pending Charges

Have you ever had a license or certification suspended or revoked?

* Please explain:

Status and Experience

Have you ever volunteered or worked for an Ascension St. Vincent Hospital?

* Please explain:

* Please share why you are interested in volunteer: