Auxiliary Application

Print out this page. After you fill in the information, you can send it to the address below or bring it to Herrin Hospital.

City, Sate

____Please contact me with more information about the auxiliary.
____Yes, I would like to be a member. Enclosed is my $5.00 annual dues. ($2.50 after October 1)

I wish to volunteer in the following areas:

______Gift Garden
______Greeter's Desk
______Hospital Services
______Surgery Hospital Desk

______I cannot serve as a volunteer at this time,
but wish to support the auxiliary as a member.

If you cannot make a weekly commitment, we need a list of persons who are willing to substitute occasionally (after initial training) in each area.

Please send your application to:
Herrin Hospital Auxiliary
c/o Membership Chairman
201 South 14th Street
Herrin, IL 62948

Herrin Hospital

201 South 14th St.
Herrin, IL 62948