Volunteer Form - RMH near Lurie Children’s

General Information

Emergency Contact


Monday MorningMonday AfternoonMonday EveningTuesday MorningTuesday AfternoonTuesday EveningWednesday MorningWednesday AfternoonWednesday EveningThursday MorningThursday AfternoonThursday EveningFriday MorningFriday AfternoonFriday EveningSaturday MorningSaturday AfternoonSaturday EveningSunday MorningSunday AfternoonSunday Evening

Once a WeekTwice a MonthOther

Family Ambassadors (greet families, assist at check-in, give families a tour and help them acclimate)Green Thumb Volunteers (nurture the garden through planting, watering, weeding, and more)House Refreshers (organize the kitchen, collect donations, stock supplies, and clean linens)Home Improvement Team (help with fix-it projects around the house)Transplant LiaisonsMeal HelperSpecial Event Volunteers

Personal References

First Reference

Second Reference

Volunteer Experience (e.g. community, civic,religious organizations):

Prior Volunteer Service #1

Prior Volunteer Service #2




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