Volunteer Application

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When you apply, you will be assigned to the Recreation Therapist. She will orient you to volunteer policies and your responsibilities as a volunteer. If you have any questions, talk to Paul Ika (QMRP) or Ron Wright (Program Director). Residents will ask you for money, food, and other various favors. Please DO NOT give them anything but your time. Although it may seem harmless, it causes unnecessary problems with our population here at Medallion.

*This form needs to be filled out completely before being allowed to volunteer*

Name *

Address: *

Phone Number: *

Number of Hours Required: *

Hours Required for: *

Supervisor: *

Supervisor Phone Number: *

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