Junior Volunteer Application (Ages 14-18)

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Junior Volunteer Application (Ages 14-18)"

Transcription

1 Volunteer Name: Volunteer Age: Volunteer Grade: Junior Volunteer Application (Ages 14-18) Medical Center Alliance 3101 North Tarrant Parkway Fort Worth, TX Phone: Fax: If you are unable to drop off application at the front desk, you are welcome to fax it to the number above.

2 Junior Volunteer Guidelines Thank you for your interest in becoming a Junior Volunteer at Medical Center Alliance. Please carefully read the guidelines and rules that apply to Junior Volunteers and have a parent or guardian read them also. I. REQUIREMENTS Jr. Volunteer Ages: Forms: All Application Forms and other required forms must be completed before you will be considered for a Junior Volunteer position. The Following items are required: Copy of current Report Card (must maintain a "B" average or higher) Copy of current up-to-date immunization record 2 letters of recommendation from someone other than a family is required. Screening: Every volunteer will have to pass a background check, drug screen and TB skin test before they can start. Interview: You will meet with the Volunteer Coordinator or Employee Health Nurse to discuss the Volunteer Guidelines, and requirements after you have completed all necessary paperwork. Service: We require a minimum of 4 hours per week per semester of service as a Junior Volunteer. This usually begins in June and ends in September of each year but may be extended on an individual by individual case. Medical: Annual PPD (Tuberculosis screening) for all Volunteers is required within 30 days of your start date. Volunteers may have these tests at Medical Center Alliance at no charge. Parental/Guardian consent for PPD is required. Medical requirements must be completed BEFORE service begins. Training: Volunteer Orientation attendance is required before you may start your service. You will be informed of the date and time of the orientation class after you are accepted to the program. II. ATTENDANCE AND ABSENCES Junior Volunteers become an integral part of their department and the Hospital staff relies on their presence as scheduled. We understand that all Volunteers may get sick, take vacations or have unavoidable conflicts (exams!) on their regular volunteer day. A message may be left on the Volunteer Coordinators phone at or when you are not able to fulfill your duties for that day. Volunteers who have taken an extended leave of absence must contact the Volunteer Coordinator before returning to service. Similarly, please notify the Volunteer Coordinator if you are resigning from the Volunteer Service and return your ID badge.

3 III. UNIFORM AND DRESS CODE Each Junior Volunteer is required to wear the correct approved Junior Volunteer uniform at all times while on duty. The Junior Volunteer required uniform is the following: Male and Female Junior Volunteer Uniforms are the same. Shirts- WHITE collared short or long-sleeve shirt. Pants - Khaki dress slacks. No hip hugger, low rider, or baggy pants allowed. Do not use perfume or other scented products as it may cause allergic reactions in some patients at any time while on duty. IV. VOLUNTEER ASSIGNMENT AND SCHEDULES Every Junior Volunteer is required to commit to an assignment of one 4 hour shift per week for a minimum of one semester commitment period. Weekend shifts are available IF APPROVED by Volunteer Coordinator. You will be given one or more regular volunteer assignments based upon the needs of the Hospital. Every effort will be made to take into account your special interests and skills. Available shifts as follows: 8:00 a.m. 12:00 p.m. Monday-Friday 1:00 a.m. 5:00 p.m. Monday-Friday Jr.Volunteer s duties include but are not limited to: Escort families, visitors to various areas as needed. Make Happy Cart rounds on all floors several times during your shift. Transport specimens, supplies, etc. to lab and other departments. Run errands as requested by unit staff Assist patient with meals - open containers, set up trays, etc. Help transport discharged patients off unit. Keep public areas tidy, uncluttered, reading materials provided. Any other duties as assigned by Director or Supervisor. We expect our Junior Volunteers to continue their tradition of mature and responsible behavior at all times. This includes a willingness to accept supervision and to follow Hospital rules. V. SIGN-IN PROCEDURE When you arrive for your shift, sign in at the front desk located on the 1st floor. Contact the nursing supervisor at *91888 and have them sign you in/out. You are responsible for keeping track of the hours you work. Please do not bring valuables or cash to the Hospital except for what you absolutely need. VI. MEAL BREAKS Your Volunteer Photo ID entitles you to one free meal in the cafeteria while on duty. Do not use your Volunteer Photo ID to purchase items from the cafeteria for anyone other than yourself. VII. PARKING Volunteers are not allowed to park in patient/visitor parking directly in front of Medical Center Alliance.

4 I, on this day, have read the guidelines to the Volunteer Program. I hereby agree to all the terms and conditions to this program. Signature of Jr. Volunteer As the parent/ legal guardian of this junior volunteer, I have reviewed these requirements and give permission for them to participate. Name: Signature: Date: In order to apply for this volunteer opportunity, you must read and agree to the terms as well as complete and return the attached forms to Medical Center Alliance front desk. For questions on the process, please contact Alex Roberson, the volunteer coordinator at or

5 JR. VOLUNTEER APPLICATION Please print clearly and answer all questions, which apply to you: Last Name First Name Middle Name Home Address City State Zip Code Home Phone Cell Phone Address: Do you work? Y or N If yes, where do you work? May we call you at work? During what days and hours? Student Grade Level What school do you attend? Days Available: Monday Tuesday Wednesday Thursday Friday Time Available: Morning or Afternoon Volunteer Category: Junior (14 to 21 years of age) Volunteer Experience Please list any volunteer experience, including school and church volunteer activities: Agency City. State Dates Duties Training, Education, Certification Please list any special training, licenses, certifications or degrees: Special interests Please list your hobbies, skills or areas of special interest: References Please list two adult personal references, other than relatives, whom you have known for at least two years: Name Address Phone Relationship Years Known

6 CONFIDENTIAL MEDICAL DISCLOSURE This form is not to be kept in the volunteer file. It is to be forwarded to Employee Health Nurse immediately upon completion. Name: Date: Address: Contact Number: Emergency Contact(s) Name: Relationship to you: Address: Phone Number: Name: Relationship to you: Address: Phone Number: Please list any medical conditions you have: I certify that the above information is true and complete to the best of my knowledge at the time of application to become a volunteer at Medical Center Alliance. I understand that it is my responsibility to update this information with the Employee Health Nurse or Volunteer Coordinator if any changes occur. I hereby give Medical Center Alliance permission to release pertinent information in the event of a medical emergency. Signature: Date:

Relationship to volunteer applicant:

Relationship to volunteer applicant: Bristol Hospital Junior Volunteer Program Parental Consent Form In order for your child to become a volunteer with us, we need your consent and your involvement in helping them have a productive experience.

More information

Volunteer Services 1950 Mountain View Ave Longmont, CO 80501 (303) 651-5205 Fax (303) 678-4851

Volunteer Services 1950 Mountain View Ave Longmont, CO 80501 (303) 651-5205 Fax (303) 678-4851 Volunteer Services 1950 Mountain View Ave Longmont, CO 80501 (303) 651-5205 Fax (303) 678-4851 Dear Prospective Junior Volunteer: Thank you for your interest in Longmont United Hospital s Junior Volunteer

More information

JUNIOR VOLUNTEER APPLICATION PACKET

JUNIOR VOLUNTEER APPLICATION PACKET APPLICATION PACKET Thank you for your interest in the Junior Volunteer Program at Nazareth Hospital. There are a limited number of positions available for Junior Volunteers during the summer. Service will

More information

APPLICATION DEADLINE: Must be received by Friday, September 19, 2014.

APPLICATION DEADLINE: Must be received by Friday, September 19, 2014. Dear Prospective Junior Volunteer: Thank you for your interest in volunteering at Robert Wood Johnson University Hospital Hamilton. Our school year junior volunteer program is for high school students

More information

SANTIAM HOSPITAL JUNIOR VOLUNTEER PROGRAM OVERVIEW

SANTIAM HOSPITAL JUNIOR VOLUNTEER PROGRAM OVERVIEW SANTIAM HOSPITAL JUNIOR VOLUNTEER PROGRAM OVERVIEW Application All prospective junior volunteers must submit an application with a signed parent permission form for entering the program. The application

More information

Junior Volunteer Program

Junior Volunteer Program 5126 Hospital Drive Covington, GA 30014 Tel: 770.788.6553 Andrea.Lane@piedmont.org Junior Volunteer Program Information Packet Piedmont Newton Hospital Volunteer Services Summer 2016 June 13 July 22 1

More information

STUDENT VOLUNTEER APPLICATION *Minimum Age for volunteers is 16*

STUDENT VOLUNTEER APPLICATION *Minimum Age for volunteers is 16* STUDENT VOLUNTEER APPLICATION *Minimum Age for volunteers is 16* CONTACT INFORMATION Name: Date: Address: Phone Number: Email: EMERGENCY CONTACT INFORMATION Emergency Contact: Relationship: Home Phone:

More information

We are excited to help you through the process to become a volunteer here at Northside Hospital Cherokee and look forward to meeting you soon.

We are excited to help you through the process to become a volunteer here at Northside Hospital Cherokee and look forward to meeting you soon. Dear Prospective Volunteer: Thank you for your interest in the volunteer program at Northside Hospital Cherokee. We are proud of the volunteer services here at Northside Cherokee. Our members are from

More information

Sincerely, Dear Volunteer Applicant,

Sincerely, Dear Volunteer Applicant, Dear Volunteer Applicant, Thank you for your interest in the volunteer opportunities within Antelope Valley Hospital. We are proud of the compassionate service our volunteers provide to our patients, visitors

More information

Friday, April 15 th Deadline for completed packet to be returned None will be accepted After this date

Friday, April 15 th Deadline for completed packet to be returned None will be accepted After this date 2016 North Cypress Medical Center Junior Volunteer Packet Must be a Current High School Sophomore or Junior If you are currently a High School Senior you will complete another application not this one.

More information

aluable for all you are and all you do. O pen to trying new things. L oyal and reliable day after day. U ntiring in your willingness to help.

aluable for all you are and all you do. O pen to trying new things. L oyal and reliable day after day. U ntiring in your willingness to help. TEEN VOLUNTEER APPLICATION 6900 North Durango Drive 2075 E. Flamingo Road 5400 Rainbow Boulevard Las Vegas, NV 89149 Las Vegas, NV 89119 Las Vegas, NV 89118 (702) 835-9861 (702) 369-7782 (702) 853-3059

More information

Dear Teen Volunteer Applicant:

Dear Teen Volunteer Applicant: Providence Holy Cross Medical Center (818) 496-4613 CAPHCMC.Volunteers@providence.org Dear Teen Volunteer Applicant: Thank you for your interest in volunteering at Providence Holy Cross Medical Center

More information

Dear Prospective Adult Volunteer:

Dear Prospective Adult Volunteer: Dear Prospective Adult Volunteer: Thank you for your interest in the Delnor Hospital Volunteer Program. We have an active program with over 550 men, women and teens contributing over 55,000 hours of volunteer

More information

REQUIREMENTS FOR VOLUNTEERS Please DO NOT send anything via fax, mail or

REQUIREMENTS FOR VOLUNTEERS Please DO NOT send anything via fax, mail or 1. Application (see next page) REQUIREMENTS FOR VOLUNTEERS Please DO NOT send anything via fax, mail or email Complete front and back. Please sign and date. 2. One Professional Letter of Reference (Typed)

More information

Tipton County Public Library Volunteer Program Policy

Tipton County Public Library Volunteer Program Policy Volunteer Program Policy Purpose The library Volunteer Program is designed to provide enrichment of the library s mission and programs. Volunteers do not replace paid staff; rather, they support the services

More information

Judy Swartz, Manager Volunteer Services/Community Relations. February 5, 2016. Dear Student and Parent/Guardian:

Judy Swartz, Manager Volunteer Services/Community Relations. February 5, 2016. Dear Student and Parent/Guardian: February 5, 2016 Dear Student and Parent/Guardian: The Volunteer Office at Deaconess Hospital is accepting applications for Junior Volunteers. The Junior Volunteer Program at Deaconess offers students

More information

All communications will be through email, so please be sure we have your email and your parent s email to avoid miscommunication.

All communications will be through email, so please be sure we have your email and your parent s email to avoid miscommunication. Volunteering as a Teen at St. Mary Note: We appreciate your attention to detail with concerns to completing this application. It is imperative that we be compliant with the various accreditation regulations

More information

Dear Prospective Volunteer:

Dear Prospective Volunteer: Dear Prospective Volunteer: Thank you for your interest in volunteering at Robert Wood Johnson University Hospital Hamilton. We accept applications from college students for summer commitments, year round

More information

Please complete the application documents and email them to the specified address. We look forward to adding you to our valued volunteer team!

Please complete the application documents and email them to the specified address. We look forward to adding you to our valued volunteer team! Dear Prospective Volunteer: We are excited that you have expressed an interest in volunteering at Doctors Hospital at White Rock Lake. As a volunteer, you will be providing services and support to patients,

More information

In order to facilitate your application, please follow these guidelines.

In order to facilitate your application, please follow these guidelines. Dear Student, Thank you for your interest in becoming a Junior Volunteer at Paoli Hospital. Enclosed please find an application and other important material. Junior Volunteers are vital to our Volunteer

More information

ADULT Volunteer Application Package

ADULT Volunteer Application Package Georgetown Hospital Site 1 Princess Anne Drive, ON L7G 2B8 ADULT Volunteer Application Package Thank you for your interest in becoming a member of our team! Volunteering with the Georgetown Hospital is

More information

Kimberley Sweet. Dear College Summer Volunteer Program Applicant:

Kimberley Sweet. Dear College Summer Volunteer Program Applicant: Dear College Summer Volunteer Program Applicant: Thanks for your interest in our summer volunteer program at Baylor Scott & White Medical Center White Rock. Volunteers are an important part of our team,

More information

COLLEGE STUDENT SUMMER PROGRAM APPLICATION - 2016. Age: Date of Birth: E-mail:

COLLEGE STUDENT SUMMER PROGRAM APPLICATION - 2016. Age: Date of Birth: E-mail: Volunteer Services Department COLLEGE STUDENT SUMMER PROGRAM APPLICATION - 2016 Name: (Last) (First) (Middle) Date: Address: (Street) (City) (State) (Zip Code) Phone: (H) (C) Age: Date of Birth: E-mail:

More information

1) The application consists of two letters of recommendation (one personal and one professional) completed by the potential Volunteer/Intern

1) The application consists of two letters of recommendation (one personal and one professional) completed by the potential Volunteer/Intern THE VOLUNTEER SERVICE DEPARTMENT Wyckoff Heights Medical Center s Volunteer Services Department is designed to assist the Medical Center with its mission of providing quality health care to the patients

More information

Enclosed for your review and completion are the following documents: Junior Volunteer Principal/Counselor Recommendation Form

Enclosed for your review and completion are the following documents: Junior Volunteer Principal/Counselor Recommendation Form Thank you for your interest in becoming a member of the UTMB Junior Volunteer Team. It is indeed refreshing to have youth volunteers willing to join hands with us to help make a difference. The UTMB Junior

More information

Saint Alphonsus Junior Volunteers

Saint Alphonsus Junior Volunteers Saint Alphonsus Junior Volunteers What is the Saint Alphonsus Junior Volunteer Program? It is an organization of teenage volunteers who give of their time, without pay, to provide essential services that

More information

A desire to meet the needs of our community, patients, families, visitors, physicians, and employees.

A desire to meet the needs of our community, patients, families, visitors, physicians, and employees. Thank you for your interest in volunteering at Memorial Regional Hospital and the Joe DiMaggio Children s Hospital. The Memorial Healthcare System is recognized as one of the outstanding Healthcare Systems

More information

JUNIOR VOLUNTEER PROGRAM

JUNIOR VOLUNTEER PROGRAM JUNIOR VOLUNTEER PROGRAM To the Applicant: Thank you for your interest in becoming a Junior Volunteer. We are excited you are pursuing an interest in serving your community. The goal of the Junior Volunteer

More information

WHAT IS EXPECTED OF A MEMORIAL REGIONAL HOSPITAL & THE JOE DIMAGGIO CHILDREN S HOSPITAL VOLUNTEER

WHAT IS EXPECTED OF A MEMORIAL REGIONAL HOSPITAL & THE JOE DIMAGGIO CHILDREN S HOSPITAL VOLUNTEER Thank you for your interest in volunteering at Memorial Regional Hospital and the Joe DiMaggio Children s Hospital. The Memorial Healthcare System is recognized as one of the outstanding Healthcare Systems

More information

TEEN VOLUNTEER APPLICATION

TEEN VOLUNTEER APPLICATION TEEN VOLUNTEER APPLICATION First Name Last Name Male/Female Date Home Phone Cell Phone Preferred Phone Address Email Want to receive our email newsletter? Y/N City State Zip Code Social Security # or provide

More information

Ambassador Application

Ambassador Application Ambassador Application Dear Applicant, Thank you for your interest in Dallas Medical Center s Ambassador Program! Your willingness to invest a few hours each week is greatly appreciated. I believe you

More information

Novant Health Auxiliary

Novant Health Auxiliary Prince William Medical Center Haymarket Medical Center Teen Volunteer 2016 Summer Program Application Form (Applicants: Must have finished at least the sophomore year of high school by summer 2016) Deadline

More information

AWCA VOLUNTEER APPLICATION

AWCA VOLUNTEER APPLICATION AWCA VOLUNTEER APPLICATION About AWCA The AWCA (Asian Women s Christian Association) is a 501(c)(3) not-for-profit organization operated by funds raised through grants, charity events, and donations. With

More information

Dear Teen Volunteer Applicant,

Dear Teen Volunteer Applicant, Dear Teen Volunteer Applicant, Thank you for considering a position with the Teen Volunteer Program at Methodist Jennie Edmundson Hospital. Since your application is very important to us, we would like

More information

Kimberley Sweet. Dear Prospective Volunteer:

Kimberley Sweet. Dear Prospective Volunteer: Dear Prospective Volunteer: We are excited that you have expressed an interest in volunteering at Doctors Hospital at White Rock Lake. As a volunteer, you will be providing services and support to patients,

More information

SCHNURMACHER CENTER FOR REHABILITATION AND NURSING

SCHNURMACHER CENTER FOR REHABILITATION AND NURSING Dear Junior Volunteer Applicant, Enclosed is an application to join the Department of Volunteers at the Schnurmacher Nursing Home. Our program is designed to allow us to adequately train and orient volunteers

More information

2016 Teen Volunteer Application Form

2016 Teen Volunteer Application Form Monona Public Library Summer Library & Reading 2016 Teen Volunteer Application Form The Teen Volunteer program is for youth entering grade 6 to entering grade 12. It is an opportunity for teens to interact

More information

Adult Volunteer Application

Adult Volunteer Application Adult Volunteer Application Thank you for your interest in s Volunteer Program. Volunteers play an important part in our hospital s effort to deliver quality healthcare to the children of East Tennessee,

More information

Thank you for your interest in volunteering with St. Michael s Hospital!

Thank you for your interest in volunteering with St. Michael s Hospital! Thank you for your interest in volunteering with St. Michael s Hospital! St. Michael s Hospital could not realize its mission and vision without volunteers. Volunteers serve in units and departments throughout

More information

Make a World of Difference at the Library Bonner Springs City Library

Make a World of Difference at the Library Bonner Springs City Library Make a World of Difference at the Library Volunteers must have completed 6 th grade. Please return by Friday, May 8th (All information must be completed in full and returned on time for consideration.)

More information

Summer Junior Volunteer Program Application. The application deadline is Tuesday, March 31, 2015.

Summer Junior Volunteer Program Application. The application deadline is Tuesday, March 31, 2015. Summer Junior Volunteer Program Application Welcome! Thank you for submitting an application to be a part of the Harris Health System Summer Junior Volunteer Program. Volunteering can be a very rewarding

More information

Auxiliary Service Positions LIVERMORE POSITIONS

Auxiliary Service Positions LIVERMORE POSITIONS Auxiliary Service Positions Volunteers are trained and not left alone until they feel comfortable performing the tasks/jobs they are asked to perform. The following are some of the duties volunteers perform

More information

All orientations are full; therefore, we are not accepting applications at this time. Please check back periodically for updates.

All orientations are full; therefore, we are not accepting applications at this time. Please check back periodically for updates. Dear Prospective Volunteer, Thank you for your interest in volunteering at your community hospital! One of the requirements for becoming a Fairview Ridges Hospital volunteer is to attend a hospital orientation

More information

Volunteering at El Paso Children s Hospital

Volunteering at El Paso Children s Hospital Volunteering at El Paso Children s Hospital El Paso Children s Hospital is making history in our community! EPCH provides excellent pediatric care and is the region s only not-for-profit, separately licensed

More information

Nurse Aide Training Program Application Checklist

Nurse Aide Training Program Application Checklist Nurse Aide Training Program Application Checklist The following checklist must be completed before enrolling in the Nurse Aide Training course: Complete, sign, and date the Application Form Have the physical

More information

PERSONAL INFORMATION

PERSONAL INFORMATION VOLUNTEER APPLICATION FORM PERSONAL INFORMATION Last Name: Street Address: City: Postal Code: Cell Phone: First Name: Apt. No. Province Home Phone: Email (print): Languages: English French Other: written

More information

We often communicate valuable program information via , so check yours regularly after submitting your application.

We often communicate valuable program information via  , so check yours regularly after submitting your application. Dear Junior Volunteer Applicant, Thank you for your interest in our Junior Volunteer program, which gives teens an opportunity to learn about healthcare by assisting staff, visitors, and patients with

More information

Thank you for your interest in completing your Student Placement with The Salvation Army Youth Outreach Service (YOS).

Thank you for your interest in completing your Student Placement with The Salvation Army Youth Outreach Service (YOS). Greetings! Thank you for your interest in completing your Student Placement with The Salvation Army Youth Outreach Service (YOS). The first step in the process is the completion and return of the attached

More information

Welcome to Lakeview Village

Welcome to Lakeview Village Welcome to Lakeview Village THANK YOU for your interest in serving at Lakeview Village! We are very excited to have you involved in our community. In order to meet the state standards, the following forms

More information

If at any time you would like to know the status of your application please Maria Strmsek or April Garcia at the addresses listed below.

If at any time you would like to know the status of your application please  Maria Strmsek or April Garcia at the  addresses listed below. Dear Volunteer Applicant: Thank you for your interest in volunteering at Henry Mayo Newhall Hospital. Please review the Volunteer application and our Eligibility and Requirements. Return the COMPLETED

More information

Community Service Policy

Community Service Policy Name: Community Service Policy The Samaritan Center welcomes volunteers, including those who are required to fulfill community service hours. To be eligible to use The Samaritan Center as a source for

More information

Island Nursing Home and Care Center Volunteer Services Application

Island Nursing Home and Care Center Volunteer Services Application Volunteer Services Application Name: Date: Address: Phone #: Date of Birth: Sex: Have you performed volunteer services in a nursing facility before? Yes No If yes, please give a brief summary of your previous

More information

Sincerely, Volunteer Services. Please return completed forms to:

Sincerely, Volunteer Services. Please return completed forms to: Congratulations and thank you for your interest in becoming a Saint Agnes Medical Center volunteer. Our volunteers are an integral part of our healing mission, and you will find them in nearly every department

More information

HOMESTAY AGREEMENT CONTRACT

HOMESTAY AGREEMENT CONTRACT Provider Code 00358C HOMESTAY AGREEMENT CONTRACT between International Student, Parent/s of International Student and Homestay Parent/s HOMESTAY AGREEMENT CONTRACT To be completed by student and parents

More information

CERTIFIED NURSING ASSISTANT COURSE TRAINING PROGRAM APPLICATION ADMISSION AND TERMINATION POLICY

CERTIFIED NURSING ASSISTANT COURSE TRAINING PROGRAM APPLICATION ADMISSION AND TERMINATION POLICY CERTIFIED NURSING ASSISTANT COURSE TRAINING PROGRAM APPLICATION ADMISSION AND TERMINATION POLICY Phone: (406) 655-5600 Fax: (406) 655-5639 www.sjlm.org Welcome to the Nursing Assistant Training Program.

More information

2015 Volunteer Manual

2015 Volunteer Manual 2015 Volunteer Manual Mission Statement Union Gospel Mission of Tarrant County is a local Christian organization and ministry dedicated to providing love, hope, respect and a new beginning to the homeless,

More information

Volunteer Services. Application Information

Volunteer Services. Application Information Volunteer Services Application Information Dear Prospective Volunteer: We want to thank you for voicing an interest in volunteer work at Inspira Medical Center Vineland! Our organization places a high

More information

SPOTSYLVANIA REGIONAL MEDICAL CENTER FREQUENTLY ASKED QUESTIONS ABOUT VOLUNTEERING

SPOTSYLVANIA REGIONAL MEDICAL CENTER FREQUENTLY ASKED QUESTIONS ABOUT VOLUNTEERING SPOTSYLVANIA REGIONAL MEDICAL CENTER FREQUENTLY ASKED QUESTIONS ABOUT VOLUNTEERING What makes a good volunteer candidate? The main factors that determine a great volunteer are: a passion for customer service

More information

ANIMAL CARE AND CONTROL Community Service Starter Packet

ANIMAL CARE AND CONTROL Community Service Starter Packet Attachment 1 ANIMAL CARE AND CONTROL Community Service Starter Packet ALL PAPEWORK MUST BE SIGNED, COMPLETED, RETURNED AND APPROVED PRIOR TO STARTING YOUR COMMUNITY SERVICE HOURS AT ANIMAL CARE AND CONTROL.

More information

Name Date (First) (MI) (Last Address (Street) (City) (State) (Zip) Phone Parent s Name. Birth Date: Age School Present Grade.

Name Date (First) (MI) (Last Address (Street) (City) (State) (Zip) Phone Parent s Name. Birth Date: Age   School Present Grade. JUNIOR VOLUNTEER APPLICATION Perth Amboy Old Bridge Perth Amboy 530 New Brunswick Avenue One Hospital Plaza Old Bridge Perth Amboy, N.J. 08861 Old Bridge, N.J. 08857 (732)442-3700 (732)360-1000 Name Date

More information

Please check the course(s) you are registering for.

Please check the course(s) you are registering for. Camp Immanuel Where Faith and Fun Come Together 18 Clapboard Ridge Road Danbury, CT 06811 www.immanueldanbury.org camp.immanuel@immanueldanbury.org 203-748-7823 Thank you for your interest in Camp Immanuel.

More information

Dear Prospective Volunteer,

Dear Prospective Volunteer, Department of Volunteer Services 1800 Orleans Street Carnegie 173 Baltimore, MD 21287-6173 410-955-5924 T 410-614-8464 F Dear Prospective Volunteer, The Department of Volunteer Services of The Johns Hopkins

More information

Volunteer Services Student Volunteer Form Packet

Volunteer Services Student Volunteer Form Packet Volunteer Services Student Volunteer Form Packet GUIDELINES This sheet must be completed and submitted as part of your student volunteer form packet. Initial on each blank line to verify you have read

More information

Note: applicants must be a Permanent Resident to be eligible to volunteer at the City of Bayswater.

Note: applicants must be a Permanent Resident to be eligible to volunteer at the City of Bayswater. APPLICATION FOR REGISTRATION AS A VOLUNTEER Title: Mr / Mrs / Ms / Miss Name: (please also list preferred name for volunteer badge) J:\COMMUNITY SERVICES\ADMINISTRATI ON\VOLUNTEERS\Forms\ Application Forms\CURRENT

More information

KCHD Personal Health Services TB Unit (616)

KCHD Personal Health Services TB Unit (616) HANDBOOK FOR THE CLIENT EXPOSED TO THE TB GERM TB Clinic Appointment at the Annex Building: Tuesday, KCHD Personal Health Services TB Unit (616) 632-7190 TB Skin Test: What does it mean? A TB skin test

More information

CHEROKEE COUNTY BOARD OF COMMISSIONERS

CHEROKEE COUNTY BOARD OF COMMISSIONERS CHEROKEE COUNTY BOARD OF COMMISSIONERS Human Resources Department 1130 Bluff Parkway Canton, GA 30114 Cherokee County E-911 150 Chattin Dr Canton, Georgia 30115 678-493-4074 678-493-4199 (fax) Dear Applicant:

More information

Dear Prospective Junior Volunteer,

Dear Prospective Junior Volunteer, Dear Prospective unior Volunteer, Thank you for expressing interest in the unior Volunteer Program at Christ Hospital. The unior Volunteer Program is an excellent opportunity for students aged 14 and above

More information

Application Summer Study - Pre-College New York Summer Study 2016

Application Summer Study - Pre-College New York Summer Study 2016 Application Summer Study - Pre-College New York Summer Study 2016 First Name Birth Date (Month/Day/Year) Address Last Name Male Female City State Zip/Country code Country Home Tel. E-mail Current School

More information

THE CARING HEART STATEMENT OF SEPERATION AGREEMENT

THE CARING HEART STATEMENT OF SEPERATION AGREEMENT THE CARING HEART STATEMENT OF SEPERATION AGREEMENT I agree during my employ and subsequent separation from The Caring Heart that I will not solicit or cultivate their clients for incorporation into establishment

More information

Application for Employment

Application for Employment Application for Employment All statements made by applicants for employment on this application form will be checked for accuracy. We offer equal employment opportunities to all persons without discrimination

More information

Dear Potential Volunteer,

Dear Potential Volunteer, Dear Potential Volunteer, Thank you for your interest in the Volunteer Services Program at CHRISTUS Santa Rosa Hospital - City Centre, Children s, Medical Center, Westover Hills and New Braunfels. To continue

More information

Heritage High School Sports Medicine. Sports Medicine Student Assistant Handbook

Heritage High School Sports Medicine. Sports Medicine Student Assistant Handbook Heritage High School Sports Medicine Sports Medicine Student Assistant Handbook Welcome to Heritage High School Sports Medicine Welcome to the Heritage High School Sports Medicine Program. By entering

More information

Tennessee State University Department of Speech Pathology & Audiology Intensive Articulation, Fluency, Language & Diagnostics Summer Speech Camp

Tennessee State University Department of Speech Pathology & Audiology Intensive Articulation, Fluency, Language & Diagnostics Summer Speech Camp Tennessee State University Department of Speech Pathology & Audiology Intensive Articulation, Fluency, Language & Diagnostics Summer Speech Camp Speech Pathology and Audiology will provide intensive therapeutic

More information

O Brien House Community Service Worker s Packet

O Brien House Community Service Worker s Packet O Brien House Community Service Worker s Packet Our Mission We save lives and families from alcoholism and drug abuse through residential treatment and community outreach. O Brien House 446 North 12 th

More information

VOLUNTEER APPLICATION PACKET

VOLUNTEER APPLICATION PACKET VOLUNTEER APPLICATION PACKET Volunteer Services 3601 A Street Philadelphia, PA 19134-1095 (215) 427-5398 We take pride in the diversity provided in our workplace and provide equal employment opportunity

More information

Center for Student Involvement

Center for Student Involvement Center for Student Involvement New Student Orientation: Summer 2015/Spring 2016 Orientation Leader Application for the Chicago Campus How to apply: 1) Carefully read the attached Orientation Leader Position

More information

Volunteer Application Form

Volunteer Application Form Volunteer Application Form Please fill out each field clearly and mail to: Volunteer Services Department 3020 Children s Way m/c 5086 San Diego, California 92123 Office (858) 966-4021 Incomplete applications

More information

Orientation Leader Application

Orientation Leader Application 2012 Orientation Leader Application MEMORANDUM To: From: Prospective Orientation Leaders Russell C. Patterson, Co-Coordinator New Student Orientation Program Frank Rampello, Co-Coordinator New Student

More information

The clinical hours will be determined according to the preceptor s schedule University of Illinois Hospital & Health Sciences System

The clinical hours will be determined according to the preceptor s schedule University of Illinois Hospital & Health Sciences System Professional Nursing Internship and Seminar Course Syllabus Spring 2015 Credits: 12.0 hours Internship Dates: January 19, 2015 - April 18, 2015 Time: The clinical hours will be determined according to

More information

SISTER CITY STUDENT EXCHANGE

SISTER CITY STUDENT EXCHANGE ENJOY TRAVEL AND INTERNATIONAL FRIENDSHIPS THROUGH THE HUNTINGTON BEACH SISTER CITY STUDENT EXCHANGE I AM INTERESTED IN ANJO, JAPAN Eligibility Any entering 9-11 th grade high school student who resides

More information

Teen Volunteer Information Packet

Teen Volunteer Information Packet Teen Volunteer Information Packet AMITA Health Adventist Medical Centers Hinsdale campus, 120 N. Oak St., Hinsdale, IL 60521 (630) 856.4000 La Grange campus, 5101 S. Willow Springs, IL 60525 (708) 245.8100

More information

Nursing Assistant I Admission Requirements

Nursing Assistant I Admission Requirements Nursing Assistant I Admission Requirements 1. High School Diploma, GED or College Transcripts 2. Driver s License or State ID 3. Social Security Card 4. Physical Examination 5. Criminal Background Check

More information

New Student Programs Summer Leadership 2011

New Student Programs Summer Leadership 2011 New Student Programs Summer Leadership 2011 SUMMER LEADER QUALIFICATIONS: There are a variety of qualities that a summer leader must have. We are looking for students who possess the following: A desire

More information

Intern and Volunteer Program Information

Intern and Volunteer Program Information Intern and Volunteer Program Information Mission Statement: is dedicated to improving the health of the community through treatment, prevention, and education Frances Nelson is a primary care medical and

More information

St. Catherine of Siena Medical Center-Volunteer Services

St. Catherine of Siena Medical Center-Volunteer Services Dear Applicant: St. Catherine of Siena Medical Center-Volunteer Services Thank you for your interest in the St. Catherine of Siena Medical Center Volunteer Program. To expedite the application process,

More information

New Student Orientation & Campus Tours 2012 Orientation Leader Information Packet

New Student Orientation & Campus Tours 2012 Orientation Leader Information Packet New Student Orientation & Campus Tours 2012 Orientation Leader Information Packet Dear Orientation Leader Applicant, We encourage you to read through this information packet very carefully. The responsibilities

More information

Shop with a Buccaneer 2014 Mentor Application

Shop with a Buccaneer 2014 Mentor Application Shop with a Buccaneer 2014 Mentor Application * * * * * * * * * * * * * * * It s hard to believe, but the Holidays are already upon us - a time for family and relaxation, but most of all, generosity. Every

More information

Junior Achievement of Southeastern Pennsylvania 2015-2016 JA Company Program Application

Junior Achievement of Southeastern Pennsylvania 2015-2016 JA Company Program Application Junior Achievement of Southeastern Pennsylvania 2015-2016 JA Company Program Application The JA Company Program is a unique experience for high school students interested in exploring their entrepreneurial

More information

Mott Community College Gateway to College

Mott Community College Gateway to College Mott Community College Gateway to College Application Package Fall 2014 Semester (Classes Begin: September 2, 2014-December 17, 2014) 709 N. Saginaw Street Flint, MI 48503 (810) 232-2690/762-5173 Address:

More information

APPLICATION FOR EMPLOYMENT

APPLICATION FOR EMPLOYMENT APPLICATION FOR EMPLOYMENT PLEASE READ BEFORE CONTINUING I agree to notify and update the Sites of any changes to the information provided. I understand that: The Sites will conduct a criminal background

More information

2015 Orientation dates: Jun 17, Aug 3, Sep 11, Sep 21 (CCH), Oct 13, Nov 12, Nov 17 (CCH), Dec 7

2015 Orientation dates: Jun 17, Aug 3, Sep 11, Sep 21 (CCH), Oct 13, Nov 12, Nov 17 (CCH), Dec 7 Volunteer Services Jody J. MacLeod, Director Hilton Head Regional Healthcare 25 Center Blvd. Hilton Head Island, SC 29926 Dear Volunteer Applicant, Tel: 843.689.8201 Fax: 843.689.8257 Email: jody.macleod@tenethealth.com

More information

LUTHERAN HEALTH NETWORK ADULT VOLUNTEER SERVICES APPLICATION

LUTHERAN HEALTH NETWORK ADULT VOLUNTEER SERVICES APPLICATION LUTHERAN HEALTH NETWORK ADULT VOLUNTEER SERVICES APPLICATION Adult - For Internal Use: Certifications: Community Service? Thank you for your interest in volunteering at Lutheran Hospital. Volunteers are

More information

for your interest in our volunteer program

for your interest in our volunteer program for your interest in our volunteer program Sinai-Grace Hospital Volunteer Checklist Complete and return a volunteer application to: Sinai-Grace Hospital, 6071 West Outer Drive, Detroit, Michigan 48235-

More information

Township of Ocean School District Oakhurst, NJ. Preschool Program School Year

Township of Ocean School District Oakhurst, NJ. Preschool Program School Year Township of Ocean School District Oakhurst, NJ Preschool Program 2015-2016 School Year Township of Ocean School District Office of Special Services 163 Monmouth Road Oakhurst, NJ 07755 James Stefankiewicz,

More information

VICTORIA GENERAL HOSPITAL

VICTORIA GENERAL HOSPITAL ADULT South Island VICTORIA GENERAL HOSPITAL ADULT VOLUNTEER APPLICATION PACKET Petra Slaughter Coordinator Volunteer Resources 1 Hospital Way Victoria, B.C. V8Z 6R5 Tel: (250) 727-4134 Fax: (250) 727-4106

More information

Thank you for your interest in volunteering at Trinitas Regional Medical Center.

Thank you for your interest in volunteering at Trinitas Regional Medical Center. Thank you for your interest in volunteering at Trinitas Regional Medical Center. Please be advised that each participant in the Trinitas Regional Medical Center Volunteer program must complete the following

More information

Anthem Career College Students at the Nashville and Memphis Locations

Anthem Career College Students at the Nashville and Memphis Locations RICHARD G. RHODA Executive Director STATE OF TENNESSEE HIGHER EDUCATION COMMISSION PARKWAY TOWERS, SUITE 1900 NASHVILLE, TENNESSEE 37243-0830 (615) 741-3605 FAX: (615) 741-6230 BILL HASLAM Governor To:

More information

Ben Lomond Elementary School 621 E. Covina Blvd. Covina, CA Phone: (626) Fax: (626)

Ben Lomond Elementary School 621 E. Covina Blvd. Covina, CA Phone: (626) Fax: (626) Ben Lomond Elementary School 621 E. Covina Blvd. Covina, CA 91722 Phone: (626) 974-4100 Fax: (626) 974-4115 August 9, 2016 Dear Families, We hope that you had a pleasant and relaxing summer. Welcome to

More information

APPLICATION FOR EMPLOYMENT

APPLICATION FOR EMPLOYMENT APPLICATION FOR EMPLOYMENT An Equal Opportunity/Affirmative Action Employer, the City of Dallas does not discriminate in employment with regard to race, color, sex, marital status, age, religion, national

More information

TRENT CE PRIMARY SCHOOL. Code of Conduct and Volunteer Policy

TRENT CE PRIMARY SCHOOL. Code of Conduct and Volunteer Policy TRENT CE PRIMARY SCHOOL Code of Conduct and Volunteer Policy Mission and Values Statement At Trent, we recognise and value the effort taken by parents and other volunteers who contribute towards school

More information