Contact Us - Antietam Health Services

	Volunteers
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	Animal Assisted Therapy
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Please use this form if you are interested in volunteering at the hospital. We will mail an application to you after receiving this information.

Due to the impending transition from Washington County Hospital to Meritus Medical Center, Volunteer Services will not process volunteer applications between October 1 and December 11. We encourage you to apply, but we will have to hold your application until December 11, 2010.

Summer positions are limited.

Name(First, Middle Initial, Last)

Home Phone Number

Address

City

State, Zip

Occupation

Are you interested in applying as a Volunteen (ages 14-18) or as an adult Volunteer?
Adult Volunteer Volunteen

Who / what interested you in volunteering?

	desire to help others
	hospital reputation
	opportunity to meet people
	opportunity to learn new things or gain job experience

Volunteer experience

Work experience

Type of volunteer service you are interested in

	clerical support (data entry, phone, filing)
	public contact (information desk, gift shop, thrift shop, coffee shop, escort, lobby guide)
	fundraising special events
	patient contact (visiting patients, nursing unit support positions designed for students seeking medical careers, care and comfort, flower delivery)
	other