LRMC Jr Volunteer Application 

-->  LRMC Junior Volunteer Program is concluded for this year, 2024.  

We will be accepting application for 2025 starting in April 2025.  

Thank you for your interest!  <--



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Thank you for your interest in our Junior Volunteer Program at Longview Regional Medical Center.  

To be accepted into our program, we require the following: 

You must be between fifteen (15) and seventeen (17) years of age.

Volunteer shifts are available Monday-Friday.

You must guarantee your own transportation to and from Longview Regional Medical Center.

You must adhere to all rules and regulations set forth for the Junior Volunteer Program at Longview Regional Medical Center.  Non-compliance of these rules may result in your dismissal as a Junior Volunteer.

After receiving notification that you have been accepted, a drug screen and TB test must be performed at the hospital prior to orientation and will be paid for by the hospital.  Your acceptance email will contain your appointment date and time as well as permission forms that must be signed by your parent/guardian.  These forms must be turned in the day of testing.  You must have a form of PHOTO identification such as a school ID or driver’s license and know your Social Security number. 

PLEASE NOTE:  The email provided in the application MUST be the student's email address not the parent/guardian's.  

Thank you again for your interest.  We look forward to your participation in our volunteer program.

Gina Tullos

Volunteer Coordinator

gina.tullos@longviewregional.com

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Email *
First Name
(Please include the name you go by if different than your legal first name)
 *
Last Name *
Phone number *
Street address *
City *
Zip *
Date of birth
(You must be between 15 and 17 years old to volunteer)
 *
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Current grade *
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School Name *
What date do you get out for the summer? *
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Parent/Guardian Name *
Parent/Guardian Phone Number *
 Parent/Guardian Email Address *
Alternate Emergency Contact Name *
Alternate emergency contact relationship to you
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Alternate emergency contact phone number *
Have you volunteered for Longview Regional previously? *
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