Critical access to quality care

Phone: (207) 288-5081
Emergencies: 911

Volunteer Application

Support Your Hospital

Interested in Volunteering?

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To learn more about volunteer opportunities within the MDI Hospital Organization, contact Brenda Sprague, Public Affairs Associate and Volunteer Coordinator, at 288-5082, ext. 1198 or This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

We invite you to complete our online Volunteer Application Form and we will do our best to match you to a position that uses your skills and interests.

Volunteer Application

Personal Information
Name:
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Email Address:
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Date
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Mailing Address:
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DOB:
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City, State & Zip:
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Occupation:
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Hobbies:
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Telephone (Home):
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Telephone (Work):
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Cell Phone:
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Are you (check one):
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Who recommended Volunteer Service at our organization to you?
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Have you been convicted of a crime or ordered to do community service? (conviction of a crime does not necessarily disqualify applicant from consideration)
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If yes, please explain:
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Do you have any limitations or health concerns, which should be taken into consideration before determining a volunteer assignment?
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If yes, please explain:
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List past volunteer experiences:
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List any professional licenses or certifications you currently hold:
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List your interests, skills and experience that may be useful to you as a volunteer:
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Emergency Contact Information
Name:
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Relationship:
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Address:
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City, State, Zip
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Telephone (Work):
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Cell Phone:
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Telephone (Home):
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Personal References

List 2 references (not relatives) familiar with your interests, skills and abilities with people.
Name
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Address
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Relationship
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Home Phone
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Work Phone
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Name
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Address
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Relationship
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Home Phone
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Work Phone
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The following is provided to help verify that you are a human being:
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Mount Desert Island Hospital; Critical Access to Quality Care Since 1897
10 Wayman Lane • Bar Harbor, ME • 04609 • (207) 288-5081

© 2012 Mount Desert Island Hospital, all rights reserved.