I confirm that I am able to commit to at least 1 regular shift per week for a period of at least 6-months.

Personal Information

Emergency Contact

Additional Information

What is your preference regarding availability? Important: Not all placements are available at any given time.

Work/Volunteer Experience (current or past)

Reference Information

References: Upon acceptance, we will be asking these individuals to complete a reference on your behalf. Please select a referee if they have known you for at least one semester/year (preference) in a professional manner (employer, supervisor, teacher, coach, etc.). We do not accept references from family, friends of family, personal friends or fellow students.
Reference 1
Reference 2


Please attach your resume here:


I acknowledge and understand that the above information is true and complete to the best of my knowledge. I understand that a false statement may disqualify me or cause my dismissal.
I have carefully considered my ability to commit to a position before submitting this application. I understand that the hospital reserves the right to release volunteers from their placement if they are unable to fulfill the duties or the time commitment required by the placement.
I understand that all volunteers must agree to provide a Vulnerable Sector Check and a Health Screening Check upon acceptance into the program. I understand that any costs associated with obtaining these documents are not covered by Mackenzie Health. *All volunteers must have received at least 2 doses of a Canada approved COVID-19 vaccine and have completed a 2-Step Tuberculin Skin Test.
I understand that there is a $30 fee required for the volunteer uniform and ID badge.
I understand that Mackenzie Health receives applications far in excess of the placements we have available and regrettably are not able to offer all candidates a placement.
I agree to receive electronic communication from Mackenzie Health and I give permission for the information I have provided on this form to be given to Mackenzie Health staff and volunteers in connection with a potential volunteer placement at the hospital. Mackenzie Health communicates via email so please make us a safe sender to ensure you recieve any correspondance from us.