Your Medical Home

Phone: (207) 288-5081
Emergencies: 911

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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 email 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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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

© 2014  Mount Desert Island Hospital, all rights reserved.