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<title>Volunteering at Henry Ford Hospital and Henry Ford Medical Centers, Henry Ford Hospital, Detroit, MI</title>
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<body bgcolor="224A73" leftmargin="0" topmargin="0" marginwidth="0" marginheight="0"><!--~ Dynamic website caching for reduced server load and increased crawlability. --><!-- links to cached pages --><noscript><table width="100%" border="0" cellspacing="0" cellpadding="0"><tr><td align="right"><a href="http://www.henryfordhealth.org/125157.cfm"><img src="http://www.henryfordhealth.org/HenryFordHealthSystem3.GIF" border="0"></a><a href="http://www.henryfordhealth.org/152378.cfm"><img src="http://www.henryfordhealth.org/HenryFordHealthSystem3.GIF" border="0"></a><a href="http://www.henryfordhealth.org/19438.cfm"><img src="http://www.henryfordhealth.org/HenryFordHealthSystem3.GIF" border="0"></a><a href="http://www.henryfordhealth.org/19147.cfm"><img src="http://www.henryfordhealth.org/HenryFordHealthSystem3.GIF" border="0"></a><a href="http://www.henryfordhealth.org/1.cfm"><img src="http://www.henryfordhealth.org/HenryFordHealthSystem3.GIF" border="0"></a><a href="http://www.henryfordhealth.org/101.cfm"><img src="http://www.henryfordhealth.org/HenryFordHealthSystem3.GIF" border="0"></a><a href="http://www.henryfordhealth.org/19085.cfm"><img src="http://www.henryfordhealth.org/HenryFordHealthSystem3.GIF" border="0"></a></td></tr></table></noscript><!-- B henryfordhealth.org ~--><!-- body ok -->
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		<td style="border-collapse:collapse;margin:0;padding:0;vertical-align:top;"><a href="http://www.henryford.com/"><img src="images/2008/logo_clear_body.gif" border="0" alt="Henry Ford Health System"></a></td>
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		<table  background="" border="0" cellspacing="0" cellpadding="0">	<tr class=""  background="">		<td class="" valign="middle" align="center" background="" title=""><a href="http://www.henryford.com"  class="">Home</a></td>		<td class="" valign="middle" align="center" background="" title=""><img src="images/2008/topnavline.gif"></td>		<td class="" valign="middle" align="center" background="" title=""><a href="body.cfm?id=48446"  class="">After Hours & Urgent Care</a></td>		<td class="" valign="middle" align="center" background="" title=""><img src="images/2008/topnavline.gif"></td>		<td class="" valign="middle" align="center" background="" title=""><a href="body.cfm?id=45404"  class="">Hospitals</a></td>		<td class="" valign="middle" align="center" background="" title=""><img src="images/2008/topnavline.gif"></td>		<td class="" valign="middle" align="center" background="" title=""><a href="body.cfm?id=37839"  class="">Medical Centers</a></td>		<td class="" valign="middle" align="center" background="" title=""><img src="images/2008/topnavline.gif"></td>		<td class="" valign="middle" align="center" background="" title=""><a href="body.cfm?id=40194"  class="">Emergency Rooms</a></td>		<td class="" valign="middle" align="center" background="" title=""><img src="images/2008/topnavline.gif"></td>		<td class="" valign="middle" align="center" background="" title=""><a href="body.cfm?id=38557"  class="">Pharmacies</a></td>	</tr></table>
	
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			<img src="images/arrowtop.gif">&nbsp;<a href="body.cfm?id=47742" class="breadcrumb">Volunteering</a>&#32;
			
			<img src="images/arrowtop.gif">&nbsp;<a href="body.cfm?id=47745" class="breadcrumb">Volunteering&nbsp;at&nbsp;Henry&nbsp;Ford&nbsp;Hospital&nbsp;and&nbsp;Henry&nbsp;Ford&nbsp;Medical&nbsp;Centers</a>&#32;
			
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						<span class="pageName"><h1>Volunteering at Henry Ford Hospital and Henry Ford Medical Centers</h1></span>
						
							
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					<input type="Text" name="eformField_4" class="metadetail" size="35" value="">
				</td>
			</tr>
			<tr class="metadetail">
				<th valign="top" class="metadetail">State&nbsp;</th>
				<td class="metadetail">
					<select name="eformField_5" id="eformField_5" class="metadetail">
						<option value=""></option>
						<option value="AK">AK</option>
						<option value="AL">AL</option>
						<option value="AR">AR</option>
						<option value="AZ">AZ</option>
						<option value="CA">CA</option>
						<option value="CO">CO</option>
						<option value="CT">CT</option>
						<option value="DC">DC</option>
						<option value="DE">DE</option>
						<option value="FL">FL</option>
						<option value="GA">GA</option>
						<option value="HI">HI</option>
						<option value="IA">IA</option>
						<option value="ID">ID</option>
						<option value="IL">IL</option>
						<option value="IN">IN</option>
						<option value="KS">KS</option>
						<option value="KY">KY</option>
						<option value="LA">LA</option>
						<option value="MA">MA</option>
						<option value="MD">MD</option>
						<option value="ME">ME</option>
						<option value="MI" selected>MI</option>
						<option value="MN">MN</option>
						<option value="MO">MO</option>
						<option value="MS">MS</option>
						<option value="MT">MT</option>
						<option value="NC">NC</option>
						<option value="ND">ND</option>
						<option value="NE">NE</option>
						<option value="NH">NH</option>
						<option value="NJ">NJ</option>
						<option value="NM">NM</option>
						<option value="NV">NV</option>
						<option value="NY">NY</option>
						<option value="OH">OH</option>
						<option value="OK">OK</option>
						<option value="OR">OR</option>
						<option value="PA">PA</option>
						<option value="PR">PR</option>
						<option value="RI">RI</option>
						<option value="SC">SC</option>
						<option value="SD">SD</option>
						<option value="TN">TN</option>
						<option value="TX">TX</option>
						<option value="UT">UT</option>
						<option value="VA">VA</option>
						<option value="VT">VT</option>
						<option value="WA">WA</option>
						<option value="WI">WI</option>
						<option value="WV">WV</option>
						<option value="WY">WY</option>
					</select>
				</td>
			</tr>
			<tr class="metadetail">
				<th valign="top" class="metadetail">Zip&nbsp;</th>
				<td class="metadetail">
					<input type="Text" name="eformField_6" class="metadetail" size="35" value="">
				</td>
			</tr>
			<tr class="metadetail">
				<th valign="top" class="metadetail">Daytime Phone Number&nbsp;<span class="required">*</span>&nbsp;</th>
				<td class="metadetail">
					<input type="Text" name="eformField_7" class="metadetail" size="35" value="">
					<input type="Hidden" name="eformField_7_required" class="metadetail" value="Daytime Phone Number is required.">
				</td>
			</tr>
			<tr class="metadetail">
				<th valign="top" class="metadetail">What would you like to offer your community?&nbsp;</th>
				<td class="metadetail">
					<textarea name="eformField_8" class="metadetail" cols="40" rows="5"></textarea>
				</td>
			</tr>
			<tr class="metadetail">
				<th valign="top" class="metadetail">Location&nbsp;</th>
				<td class="metadetail">
					<select name="eformField_9" id="eformField_9" class="metadetail">
						<option value="" selected></option>
						<option value="Detroit">Detroit</option>
						<option value="Ann Arbor">Ann Arbor</option>
						<option value="Lakeside">Lakeside</option>
						<option value="Taylor">Taylor</option>
						<option value="West Bloomfield">West Bloomfield</option>
						<option value="Wyandotte">Wyandotte</option>
					</select>
				</td>
			</tr>
			<tr class="metadetail">
				<th valign="top" class="metadetail">Skills (select all that apply):&nbsp;</th>
				<td class="metadetail">
					<nobr><input type="checkbox" name="eformField_10" id="eformField_10_1" style="{border:0;}" value="Child Care">
					<label for="eformField_10_1" class="metadetail">Child Care</label></nobr><br>
						<script language="JavaScript" type="text/javascript"><!--
						smm_eforms_toggle_other_to_init[smm_eforms_toggle_other_to_init.length] = "eformField_10_1";
						//--></script>
					<nobr><input type="checkbox" name="eformField_10" id="eformField_10_2" style="{border:0;}" value="Elder Care">
					<label for="eformField_10_2" class="metadetail">Elder Care</label></nobr><br>
						<script language="JavaScript" type="text/javascript"><!--
						smm_eforms_toggle_other_to_init[smm_eforms_toggle_other_to_init.length] = "eformField_10_2";
						//--></script>
					<nobr><input type="checkbox" name="eformField_10" id="eformField_10_3" style="{border:0;}" value="CPR">
					<label for="eformField_10_3" class="metadetail">CPR</label></nobr><br>
						<script language="JavaScript" type="text/javascript"><!--
						smm_eforms_toggle_other_to_init[smm_eforms_toggle_other_to_init.length] = "eformField_10_3";
						//--></script>
					<nobr><input type="checkbox" name="eformField_10" id="eformField_10_other" style="{border:0;}" value='Other' onClick="return smm_eforms_toggle_other(this);">
					<label for="eformField_10_other" class="metadetail">Other</label></nobr>
					<div class="metanew">
						<p class="metanew">
							If Other, please specify:<br>
							<textarea cols="30" rows="3" wrap="soft" name="eformField_10_other_txt" id="eformField_10_other_" disabled class="metadetail"></textarea>
						</p>
					</div>
					<script language="JavaScript" type="text/javascript"><!--
					smm_eforms_toggle_other_to_init[smm_eforms_toggle_other_to_init.length] = "eformField_10_other";
					//--></script>
					<input type="hidden" name="eformField_10_other_txt_required" value='Please provide further details to your answer: Other.' disabled>
				</td>
			</tr>
			<tr class="metadetail">
				<th valign="top" class="metadetail">Please list other skills:&nbsp;</th>
				<td class="metadetail">
					<textarea name="eformField_11" class="metadetail" cols="40" rows="5"></textarea>
				</td>
			</tr>
			<tr class="metadetail">
				<th class="metadetail">&nbsp;</td>
				<td class="metadetail">
					<input type="submit" name="submit" value="Submit" class="metadetail">
				</td>
			</tr>
		</table>
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	<br>1-800-HENRYFORD (800-436-7936)&nbsp;&nbsp;&nbsp;&nbsp;Copyright 1997 - 2010</td>
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