Prospective Volunteer Application

A Parental/Legal Guardian Consent Form must be completed for all volunteers under age 18. Applicants under the age of 15 may not volunteer at Shirley Ryan AbilityLab.

Please remember the User-ID and Password you enter below. This information you will use to complete your onboarding in the future.

New User Details

User ID

User ID (verify)

Password

Password (verify)

* First name

Middle name

* Last Name

Preferred name

Suffix

* Home Address

Address Line 2

* City

* State

* Zip/postal

Country code (by name)

* Phone (Mobile)

Phone (Other)

* E-mail Address

* Date of Birth

Gender

Interest

What interests you in the volunteer program at Shirley Ryan AbilityLab?

What area are you interested in volunteering

Commitment

The Volunteer Program generally requires a 100 hour commitment with a once a week, 3-4 hour shift. We ask for a consistent shift commitment in order to provide the best possible care for our patients.

Are you able to make a commitment of this nature?

Are you a former patient of Shirley Ryan AbilityLab?

I would like a full day

Agreement

I understand and agree that submitting this questionnaire DOES NOT automatically register me as a Shirley Ryan AbilityLab volunteer.

Additional steps: required medical documents (immunization records for MMR and varicella, proof of TB immunity, and current flu shot), participate in a phone interview, and complete Online Training, then followed by a criminal background check. You will receive an email with additional details within a week of submission.

(Please check your email spam folder as this email can sometimes show up there.)

By submitting this form, I attest that the information I have provided on the form is true and accurate.

* I agree