Dickinson, North Dakota
(701) 483-5000
St. Luke’s Home
Park Ave Villa
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Dickinson, North Dakota

Volunteer Application

Volunteer Application

Volunteer Application



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Hobbies, Skills, Talents, Special Interests, Special Training
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Schedule Preferred

Nearest Relative


Have you performed volunteer services in a nursing facility before?
Do you enjoy working with Senior Citizens?
Do you have any relatives in this nursing facility?
Have you ever had any relatives in a nursing faculity?
Do you think nursing facilities provide needed services?
Will you be willing to provide volunteer services to this facility?

How many hours can you donate?

On what days would you be available?
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What time of day would you be available?
If selected to participate in our volunteer program, do you agree to abide by the rules and regulations established by this facility?


If you are 17 years old or younger, please bring a permission letter from a parent or guardian