Volunteer Interest Form

This form is for individuals 18 and over. Individuals interested in our Junior Volunteer Program (for ages 15-17) should call (631) 474-6365 to request an application. 

Thank you for your interest in the Volunteer Program at St. Charles Hospital.  Our priority is for our program to be mutually beneficial for its participants and the hospital.  Please rest assured that every effort will be made to accommodate your interests and goals while being matched to an opportunity that we have available within one of our areas. 


Check all that apply
Check all that apply

New York State Health Dept Code #405 mandates physical examinations for volunteers working in the hospital.