Become a Lima Memorial Volunteen

PLEASE NOTE:

You will be contacted for the date and time of the next Volunteen orientation.

Each orientation session will now provide information on Patient Care. Although Patient Care is not mandatory for the majority of hospital assignments, it is a necessary curriculum for students who wish to have direct patient contact. Patient Care assignments are open to students who are at least 16 years of age or 15 years of age with one year of volunteer experience.

Contact the Lima Memorial Volunteer Services Department at 419-226-5094 for more information.

Volunteen Application

Please complete the fields below.

Requirements

First Name *

Middle Initial *

Last Name *

Preferred Name

Age (as of May 1, 2025) *

Date of Birth *

Home Address *

City *

State *

Zip Code *

Email Address *

Cell Phone Number *

Parent's Name(s) *

Emergency Contact First and Last Name *

Emergency Contact Relationship *

Emergency Contact Preferred Phone Number 1 *

Emergency Contact Preferred Phone Number 2

Emergency Contact Email Address *

High School Name *

Graduation Year *

Do you consent to us contacting your school Guidance Counselor for a reference? *

Yes

Guidance Counselor name

Please mark the volunteer service area(s) you are interested in: *

Patient & Visitor Escort

Gift Shop

Nursing Unit Assistant

Information Desk Greeter

Cafeteria Worker

Clerical

Other volunteer service (Do you have something else in mind that isn't listed above? Please list it here):

Any other scheduling requests you may have:

Please list any extracurricular activities that might interfere with your ability to fulfill your schedule (i.e. sports, band, camp, family vacation). *Please note that this does not disqualify you from volunteering, it's more to help us with scheduling. *

Please tell us why you want to volunteer: *

Career Interests: *

What hobbies do you have? *

Date *

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Instructions