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Apply to Volunteer
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Apply to Volunteer

Pattie A. Clay Regional Medical Center is always looking for active, caring individuals to serve as volunteers for a variety of positions. If you are interested in volunteering, please complete the volunteer application form below, or download and print the volunteer application.

 

Volunteer contact: Jerian Shaw at 859-625-3446 or click here to email Volunteer Services.

 

Date: 
*

Name:

Address:

Telephone:

*

E-mail: 
*

Birthdate:

*

Days/Times I prefer to work: 

Why I want to be a volunteer:

*

Do you have previous volunteer experience?

 Yes
No

If Yes, where?: 

Please enter the characters seen in the image below.
    

 
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