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Ask a Health Educator

Volunteer Registration
To become a volunteer, please complete the following application form.




* Indicates required information
Name * 
Date 
Street 
Town/City 
State 
Zip Code 
Email Address * 
Telephone Number 
Are you at least 16 years old? * 
Former/Current Occupation 
Education - last year completed 
Brief description of types of jobs you have held in the past 
Job skills or special training 
Membership in other community organizations 
Prior volunteer experience 
Why do you want to volunteer with us? 
How did you hear about this program? 
Do you have reliable transportation? 
Do you have family members who work for our organization? 
Have you any handicaps or health conditions which should be taken into consideration before determining a volunteer assignment? 
Emergency Contact:
Name, Address and Telephone 
Days Preferred 
Hours Preferred 
Personal references (no relatives, please). Please list 2, and include address and telephone #. 
Please refer any questions to Human Resources at (207) 744-6070 
Authentication * 

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181 Main Street, Norway, Maine 04268 | (207) 743-5933, TTY (for the hearing impaired): (207) 743-1597