Application for Summer Junior Volunteer Program (15-17yrs)

Size: px
Start display at page:

Download "Application for Summer Junior Volunteer Program (15-17yrs)"

Transcription

1 Application for Summer Junior Volunteer Program (15-17yrs) This Packet Includes: Application Personal Essay Recommendation Form (Must have at least 1 but may have 2 recommendations completed by a teacher or a counselor) Please complete all required forms for your packet to be considered. The deadline to submit your packet is: THURSDAY, FEBRUARY 25 BY NOON No exceptions 50 positions are available To submit your packet please to: volunteers@chla.usc.edu IS THE ONLY MEANS BY WHICH WE WILL ACCEPT YOUR APPLICATION. Applicants will be notified by mail beginning March 7, 2016

2 Children s Hospital Los Angeles Application for Summer Junior Volunteer Program (15-17 yrs) PLEASE TYPE DATE First Name Middle Name or Initial Last Name Street Address City Zip Social Security Number Birthday (Month/ Date/ Year) Gender (Please mark) M F Home Phone Driver License Number and State (if applicable) Mobile Phone Have you ever been convicted of a crime (other than a minor traffic violation)? If yes, please explain No Yes Name of High School Grade Level Last Day of School First Day of School Previous or current volunteer experience Emergency Contact Relationship to the above Phone Days & Shifts are as follows: Monday through Friday AM 9:00 12:30 or PM 1:00 4:30 Volunteers must commit to 3 shifts per week Please indicate your availability below MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY AM PM AM PM AM PM AM PM AM PM

3 Volunteer Agreement and Certification of Information Believing that Children s Hospital Los Angeles has need of my services as a volunteer, I agree: To hold as absolutely confidential all information which I may obtain directly or indirectly concerning patients, parents, doctors, or personnel, and will not seek confidential information in regard to a patient. To commit to 3 times a week for 3.5 hrs a day in a solid block of time from June 20 to August 5, 2016 and to attend the General Orientation on Saturday, June 18, That my services are donated to Children s Hospital Los Angeles without contemplation of compensation, or future employment, and given with humanitarian or charitable reasons. I certify that the answers given by me to the foregoing questions and statements are true, correct, and without omissions. I authorize Children s Hospital Los Angeles to investigate and/ or verify the foregoing information and any other information, which might assist them in determining my qualifications for volunteering. I release Children s Hospital Los Angeles and my former employers, and all others from any liability from damage, which may result from such investigation, if, upon investigation, anything contained in this application is found to be untrue. I further agree to conform to the rules and regulations of this facility. I understand that my volunteer status at Children s Hospital Los Angeles can be terminated at any time for failure to comply with the policies, rules, and regulations of the Hospital including those of the volunteer department; for absences without notification; for reasons of unsatisfactory attitude, work or appearance; and for any other circumstances which, in the judgment of the Hospital, would make my continued service as a volunteer contrary to the best interests of the Hospital. I also understand that no one has any authority to enter into any agreement for employment for any specified period of time or to make any agreement contrary to the foregoing, except for a written employment agreement signed by an administrative representative of this facility. ANY PERSON WHO INTENTIONALLY GIVES MISLEADING OR FALSE INFORMATION WILL BE SUBJECT TO IMMEDIATE TERMINATION. Print Name: Date: Signature: JUNIOR VOLUNTEER PARENT/GUARDIAN CONSENT FORM I authorize my daughter son age to participate in the Junior Volunteer Program at Children s Hospital Los Angeles, and to engage in such volunteer activities as may be assigned by the Manager, or a designated representative. I give my permission to the Hospital for the administration of any minor treatment, should it be deemed necessary. I release Children s Hospital Los Angeles from any claim or liability for any injury or illness resulting to said minor, not occasioned by any fault or neglect on the part of the Hospital, while participating in such volunteer activities. Signed:

4 Personal Essay: For your application to be considered, you must complete a personal essay. The essay must be one full page, double-spaced and typed in size 12 Times New Roman Font. In recognizing your passion for children, please tell us why you should be considered for a volunteer position at Children s Hospital Los Angeles.

5 Children s Hospital Los Angeles Summer Junior Volunteer Program RECOMMENDATION FORM INSTRUCTIONS Dear Teachers And Counselors, Thank you for your willingness to complete the recommendation on behalf of this candidate to volunteer for CHLA. Our Summer Junior Volunteer Program offers mature teens an opportunity to be of service to our patients, families and staff of Children s Hospital Los Angeles. Our decisions on who to accept are based on matching the needs of our Hospital. We rely on recommendations, such as yours, in helping us identify those who will both match and benefit from our program. Here are some of the criteria we are looking for in a candidate: Has a strong need to be of service Demonstrates an ability to make the most of learning opportunities Is mature, self-directed Is intellectually capable, although academic performance per se is not a factor in admission Has demonstrated behaviors suggestive of the desire to make a positive contribution (i.e. volunteering, tutoring) Demonstrates regard for others, empathy, natural courtesy in daily interactions Since this recommendation will be returned to the student, you may call us at if you have reservations about your recommendation. Please print clearly or type. A prompt reply is appreciated. Please return the completed forms directly to the applicant. Do not send directly to Children s Hospital Los Angeles. Thank you, Volunteer Resources Department

6 Children s Hospital Los Angeles Summer Junior Volunteer Program RECOMMENDATION FORM *Please refer to the Recommendation Instructions for guidance. NAME OF APPLICANT 1. How long have you known the applicant and what is your relationship? 2. Why do you think the applicant is applying to volunteer? 3. Based on the criteria, please identify and or describe the behaviors the applicant consistently demonstrates. 4. Identify and or describe behaviors demonstrated that need improvement? 5. Please comment about the applicant s potential for future professional success in a healthcare field. 6. Additional comments. 7. Summary Evaluation. Using the chart below, please rate the applicant relative to others you have known in a similar capacity.

7 OUTSTANDING EXCELLENT GOOD FAIR POOR NOT OBSERVED Motivation to learn Interest in well-being of others Intellectual potential Leadership potential Judgment Maturity Self- Directed Communication skills: oral Communication skills: written Organizational skills Ability to analyze a problem and formulate a solution Relationship/Collaborative ability to work with others Ability to work independently General knowledge level Motivation for pursuing a career in healthcare Please Print Name Professional Title School Phone Number Full Address Date Please return this form to the applicant for inclusion in their application packet. Thank you.

Children s Hospital Los Angeles Application for Volunteer Service (Adult 18+)

Children s Hospital Los Angeles Application for Volunteer Service (Adult 18+) Children s Hospital Los Angeles Application for Volunteer Service (Adult 18+) PLEASE TYPE DATE First Name Middle Name or Initial Last Name Street Address City Zip Social Security Number Birthday (Month/

More information

EMPLOYMENT APPLICATION {PLEASE Print Clearly}

EMPLOYMENT APPLICATION {PLEASE Print Clearly} Date Received: Next Step: EMPLOYMENT APPLICATION {PLEASE Print Clearly} Date: Position applied for: Personal Information Legal Name: First Last Middle Initial Address: Street City State Zip code How long

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

Ohiopyle Prints, Inc.

Ohiopyle Prints, Inc. Ohiopyle Prints, Inc. 410 Dinner Bell Road Ohiopyle, PA 15470 724-329-4652 2016 STUDENT SUMMER WORK PROGRAM Starting Pay $7.25 / hr $50 Attendance Bonus Plan Must be 16 years or older and have a valid

More information

RARITAN BAY AREA YMCA

RARITAN BAY AREA YMCA Dear Applicant, Enclosed please find the Youth Leaders & Junior Counselor In Training Application and the Camp Registration Packet. Please complete the application and return all documents with your $100.00

More information

Pyro-Comm Systems, Inc...

Pyro-Comm Systems, Inc... Pyro-Comm Systems, Inc... 15531 CONTAINER LANE HUNTINGTON BEACH, CA 92649P (714) 902-8000 F (714) 902-8001 EMPLOYMENT APPLICATION Position(s) Applied For Date of Application Last Name First Name Middle

More information

Target Store Recruitment Application Form

Target Store Recruitment Application Form Store Use Only to be completed upon receipt of application from applicant Store Number: Is privacy statement signed? Yes Received By: Date Received: Has applicant retained Reference Page? Yes Target Store

More information

Eleanor Roosevelt High School: National Honor Society Application

Eleanor Roosevelt High School: National Honor Society Application Eleanor Roosevelt High School: National Honor Society Application Full Name Do Not Write in This Space-NHS Faculty Use Address City, State, Zip Date Application Received Date Application Reviewed Phone

More information

VOLUNTEER APPLICATION

VOLUNTEER APPLICATION VOLUNTEER APPLICATION The information on this application will help us find the most satisfying and rewarding volunteer service for you. You may include any additional information by attaching it to the

More information

2016 Scholarship Application Timeline

2016 Scholarship Application Timeline 2016 Scholarship Application Timeline Applications Process: April 1 - May 16, 2016 Interview Notifications Sent By: May 17 th via email Scholarship Interviews: Friday, May 20, 2016 Selection Notifications

More information

Address: Street. If you are under 18 years of age, do you have a work permit? Yes If you have ever worked under another name, please identify:

Address: Street. If you are under 18 years of age, do you have a work permit? Yes If you have ever worked under another name, please identify: APPLICATION FOR EMPLOYMENT Miles farmers market 28560 Miles Road, Solon, OH 44139 ph 440.248.5222 toll free 800.646.4537 fx 440.248.7518 www.milesfarmersmarket.com Thank you for your interest in applying

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

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

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

Rose Bowl Aquatics Center Application for Employment

Rose Bowl Aquatics Center Application for Employment Rose Bowl Aquatics Center Application for Employment Applicants may be tested for illegal drugs PERSONAL INFORMATION Date Completed: Social Security Number: - - Present Last First Middle Maiden Number

More information

Business, Marketing, Culinary Arts, Hotel/Lodging Management or Event Planning

Business, Marketing, Culinary Arts, Hotel/Lodging Management or Event Planning Dear Student, Are you interested in Business, Marketing, Culinary Arts, Hotel/Lodging Management or Event Planning? Then you would be interested in the Hospitality Careers Academy! You could be chosen

More information

Orientation Leader. application information. Orientation Leader Position Description. Minimum Qualifications

Orientation Leader. application information. Orientation Leader Position Description. Minimum Qualifications Position Description The New Student Orientation Program will select a group of dedicated leaders who are current Schoolcraft students to directly work with incoming students and family members. Orientation

More information

Bethalto Public Library District EMPLOYMENT PREVIEW

Bethalto Public Library District EMPLOYMENT PREVIEW EMPLOYMENT PREVIEW We are pleased that you are interested in employment with the Bethalto Public Library District. Please allow us to preview what you can expect while working for the Library. Public libraries

More information

BACHELOR OF SOCIAL WORK Candidacy Application

BACHELOR OF SOCIAL WORK Candidacy Application BACHELOR OF SOCIAL WORK Candidacy Application Procedure/Policy and Practice Social Work majors formally apply to the School of Social Work for admission to the program by completing the Bachelor of Social

More information

2014 Project 150 Scholarship Program. Application Timeline

2014 Project 150 Scholarship Program. Application Timeline 2014 Project 150 Scholarship Program Application Timeline o Application Accepted April 29 thru May 13, 2014 o Scholarship Interviews May 15, 2014 o Selection Notifications Sent by May 16, 2014 via email

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

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

EMPLOYMENT OPPORTUNITY Preschool Playgroup Instructor Assistant Parks & Recreation Division

EMPLOYMENT OPPORTUNITY Preschool Playgroup Instructor Assistant Parks & Recreation Division EMPLOYMENT OPPORTUNITY Preschool Playgroup Instructor Assistant Parks & Recreation Division City of Mill Creek, 15728 Main Street, Mill Creek, WA 98012 425-745-1891 SALARY RANGE: $11.23 - $14.79 per hour

More information

1. COMPLETE & SUBMIT YOUR APPLICATION

1. COMPLETE & SUBMIT YOUR APPLICATION Dear Prospective Young At Art Museum Teen Volunteer, YAA Teen Leadership Program Sponsored by American Express Charitable Fund Thank you for your interest in volunteering with Young At Art Museum. The

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

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

LEAGUE CITY VOLUNTEER FIRE DEPARTMENT

LEAGUE CITY VOLUNTEER FIRE DEPARTMENT LEAGUE CITY VOLUNTEER FIRE DEPARTMENT 555 W. Walker Phone 281-554-1465 Dear Applicant: Thank you for your interest in becoming a member of the League City Volunteer Fire Department. Our success as a community

More information

EMPLOYMENT APPLICATION

EMPLOYMENT APPLICATION EMPLOYMENT APPLICATION Thank you for your interest in the YMCA of Metropolitan Detroit! The YMCA of Metropolitan Detroit is an equal opportunity employer and does not discriminate in recruitment, hiring

More information

Friends of Harold Washington College Graduation Award

Friends of Harold Washington College Graduation Award The Award: Friends of Harold Washington College (FHWC) is an organization of faculty, staff and administrators who have retired from full time service to the college. The Friends of Harold Washington College

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

First Name Last Name. Street Address. City/State/Zip Code. Home Phone Cell Phone. Date of Birth Social Security # School Name Grade

First Name Last Name. Street Address. City/State/Zip Code. Home Phone Cell Phone. Date of Birth Social Security # School Name Grade Teen Summer Camp Volunteer Program Job Description Teen Summer Camp Volunteer Program Teen Camp Counselor Application Date First Name Last Name Street Address City/State/Zip Code Home Phone Cell Phone

More information

Teen Photography Program Scholarship Application 2015-2016 School Year

Teen Photography Program Scholarship Application 2015-2016 School Year Please return this application to: Mail: NYC SALT 214 W. 29 th Street, Suite 1401 NY, NY 10001 a scanned copy to: alicia@nycsalt.org Teen Photography Program Scholarship Application 2015-2016 School Year

More information

New Student Orientation 2016 Orientation Leader Application

New Student Orientation 2016 Orientation Leader Application New Student Orientation 2016 Please make sure that you read through the entire packet. It is very important that you follow all of the steps in the application process in order to be considered an applicant

More information

Your Career: RADIOLOGY Program Application

Your Career: RADIOLOGY Program Application Your Career: RADIOLOGY Program Application Submit all Application Materials to: Good Samaritan Hospital Radiography Program ATTN: Marsha Cox 520 S. 7 th Street Vincennes, IN 47591 Page 2 APPLICATION PROCESS

More information

Business, Marketing, Culinary Arts, Hotel/Lodging Management or Event Planning guest speakers in the industry

Business, Marketing, Culinary Arts, Hotel/Lodging Management or Event Planning guest speakers in the industry Dear Student, Are you interested in Business, Marketing, Culinary Arts, Hotel/Lodging Management or Event Planning? Then you would be interested in the Hospitality Careers Academy! You could be chosen

More information

BRAG PACKET RECOMMENDATION GUIDELINES

BRAG PACKET RECOMMENDATION GUIDELINES BRAG PACKET RECOMMENDATION GUIDELINES If you are requesting a recommendation and/or secondary school report from your counselor to a college or university for admission or scholarship consideration, please

More information

HERKIMER BOCES SUBSTITUTE STAFF CALLING SERVICE

HERKIMER BOCES SUBSTITUTE STAFF CALLING SERVICE HERKIMER BOCES SUBSTITUTE STAFF CALLING SERVICE Teacher, Teaching Assistant, or Teacher Aide Complete the attached application form. Ask individuals to complete the attached reference forms and have them

More information

CIVIL SERVICE COMMISSION CITY OF TYLER, TEXAS. Announces an Examination for FIRE RECRUIT

CIVIL SERVICE COMMISSION CITY OF TYLER, TEXAS. Announces an Examination for FIRE RECRUIT CIVIL SERVICE COMMISSION CITY OF TYLER, TEXAS Announces an Examination for FIRE RECRUIT ANNOUNCENIENT OPENS: TUESDAY, APRIL 2, 2013 AT 9:30 A.M. APPLICATION DEADLINE: FRIDAY, MAY 3, 2013 AT 5:00 P.M. TEST

More information

JUNE 20 24, 2016 VIDEO GAME DEVELOPMENT SUMMER CAMP

JUNE 20 24, 2016 VIDEO GAME DEVELOPMENT SUMMER CAMP Attention upcoming 7 th - 10 th graders: You are invited to join the IT and Web Design faculty at Carteret Community College for an action packed week of Video Game Design, Development, and Play. JUNE

More information

A Guide to Completing the Application for the University of Hawai i at Hilo Master of Arts in Teaching

A Guide to Completing the Application for the University of Hawai i at Hilo Master of Arts in Teaching A Guide to Completing the Application for the University of Hawai i at Hilo Master of Arts in Teaching MAT Application Checklist UH Hilo application form $50 Application fee Personal statement: Interest

More information

2013 Orientation Leader

2013 Orientation Leader 2013 Orientation Leader Make an impact on Someone s life by becoming a FALL 2013 Orientation Leader Make an impact Information Packet & Application Information packets and applications will also be available

More information

Florence-Lauderdale Public Library Application for Employment

Florence-Lauderdale Public Library Application for Employment The Florence-Lauderdale Public Library takes unsolicited applications for general library work, full-time or part-time. The following description is for such general work which may be performed under a

More information

HCC Coleman College Dental Hygiene Program Fall Application Packet

HCC Coleman College Dental Hygiene Program Fall Application Packet HCC Coleman College Dental Hygiene Program Fall Application Packet Application Deadline: April 8, 2016, 12:00noon Thank you for your interest in the Coleman College for Health Sciences Dental Hygiene Program.

More information

2015 High School Graduate Scholarship Application

2015 High School Graduate Scholarship Application 2015 High School Graduate Scholarship Application For any questions please contact your Admissions Representative Scholarship overview Application due date: May 4, 2015 The Ogle High School Scholarship

More information

2016 Master Gardener Volunteer Training Program

2016 Master Gardener Volunteer Training Program 2016 Master Gardener Volunteer Training Program The Master Gardener Volunteer Program is a joint effort by Cornell Cooperative Extension (CCE) and its trained volunteers to deliver the best research-based

More information

APPLICATION FOR EMPLOYMENT

APPLICATION FOR EMPLOYMENT APPLICATION FOR EMPLOYMENT The Town of East Hampton is an equal opportunity employer and does not discriminate on the basis of race, religion, color, national origin, age, sex, gender, disability or any

More information

Kean University School of General Studies General Education Mentor (GEM) Peer Leadership Program Undergraduate Student Employment Application

Kean University School of General Studies General Education Mentor (GEM) Peer Leadership Program Undergraduate Student Employment Application General Education Mentor (GEM) Peer Leadership Program Undergraduate Student Employment Application This application packet contains the following: General Job Description and Expectations Mission, Goals,

More information

The 2016 San Francisco Police Foundation High School Student Stipend Internship

The 2016 San Francisco Police Foundation High School Student Stipend Internship The 2016 San Francisco Police Foundation High School Student Stipend Internship SFPD Youth and Community Engagement Unit 1245 3 rd Street, 5 th Floor San Francisco, CA 94158 Officer Raphael Rockwell Email:

More information

TEAM LEADER & ORIENTATION LEADER APPLICATION FOR SUMMER 2016

TEAM LEADER & ORIENTATION LEADER APPLICATION FOR SUMMER 2016 TEAM LEADER & ORIENTATION LEADER APPLICATION FOR SUMMER 2016 POSITION DESCRIPTION Orientation plays a key role in the success of first-year students by providing a fun, safe and positive environment designed

More information

Dear Prospective Applicant,

Dear Prospective Applicant, Branson Tourism Center 220 Branson Hills Parkway, Suite K Branson, MO 65616 (417) 334-4400 (417) 334-4588 FAX Dear Prospective Applicant, www.bransontourismcenter.com Welcome to Branson Tourism Center.

More information

volunteer opportunities

volunteer opportunities volunteer opportunities Volunteering is a truly worthwhile experience. Organizations that utilize volunteers benefit by having added resources to sustain, expand or introduce new initiatives which generate

More information

TOWN OF ELLINGTON 55 Main Street P. O. Box 187 Ellington, Connecticut 06029-0187 www.ellington-ct.gov APPLICATION FOR EMPLOYMENT

TOWN OF ELLINGTON 55 Main Street P. O. Box 187 Ellington, Connecticut 06029-0187 www.ellington-ct.gov APPLICATION FOR EMPLOYMENT TOWN OF ELLINGTON 55 Main Street P. O. Box 187 Ellington, Connecticut 06029-0187 www.ellington-ct.gov APPLICATION FOR EMPLOYMENT Position applied for: You must fill out this application completely even

More information

Junior Volunteer Application (Ages 14-18)

Junior Volunteer Application (Ages 14-18) Volunteer Name: Volunteer Age: Volunteer Grade: Junior Volunteer Application (Ages 14-18) Medical Center Alliance 3101 North Tarrant Parkway Fort Worth, TX 76177 Phone: 817-639-1000 Fax: 817-639-1727 If

More information

EMPLOYMENT APPLICATION

EMPLOYMENT APPLICATION 301 Church Avenue, Knoxville TN 37915 APPLICANT INSTRUCTIONS: If you need assistance filling out this application form please contact KAT at (865) 215-7800. 1. Please read "APPLICANT NOTE" below. 2. Complete

More information

CITY OF ASHTABULA NOTICE OF CIVIL SERVICE EXAM ENTRANCE FIRE FIGHTER

CITY OF ASHTABULA NOTICE OF CIVIL SERVICE EXAM ENTRANCE FIRE FIGHTER CITY OF ASHTABULA NOTICE OF CIVIL SERVICE EXAM ENTRANCE FIRE FIGHTER SATURDAY, FEBRUARY 22, 2014 FROM 9:00 AM TO 11:30 PM REGISTRATION STARTING AT 8:00 AM, PLEASE BRING A PHOTO ID LOCATION: CRISTAL GLOBAL

More information

Eligibility and Requirements THE JOHN R. KERNODLE, JR. MEMORIAL SCHOLARSHIP

Eligibility and Requirements THE JOHN R. KERNODLE, JR. MEMORIAL SCHOLARSHIP Eligibility and Requirements THE JOHN R. KERNODLE, JR. MEMORIAL SCHOLARSHIP The John R. Kernodle, Jr. Memorial Scholarship was established in 1996 by a group of Guilford County citizens in memory of John

More information

North Central Wisconsin

North Central Wisconsin DIRECTIONS FOR COMPLETING APPLICATION PORTFOLIO It s recommended that every student interested in participating in a Youth Apprenticeship Program submit an application portfolio when applying for a position

More information

2015 SUMMER INTERNSHIP PROGRAM INFORMATION PACKET AND APPLICATION

2015 SUMMER INTERNSHIP PROGRAM INFORMATION PACKET AND APPLICATION 2015 SUMMER INTERNSHIP PROGRAM INFORMATION PACKET AND APPLICATION What is the Summer Internship Program? Bellevue Hospital Center Internship Overview and Fact Sheet The is an internship for college students

More information

MENTAL HEALTH TRAINING PROGRAM Funded by the Mental Health Services Act (MHSA) All sections must be completed or the application will not be reviewed

MENTAL HEALTH TRAINING PROGRAM Funded by the Mental Health Services Act (MHSA) All sections must be completed or the application will not be reviewed MENTAL HEALTH TRAINING PROGRAM Funded by the Mental Health Services Act (MHSA) All sections must be completed or the application will not be reviewed Final Year Students admitted into the two, three or

More information

Target Store Recruitment Application Form

Target Store Recruitment Application Form Store Use only to be completed upon receipt of application from applicant Store Number: Is privacy statement signed? Received By: Date Received: Has applicant retained Reference Page? Target Store Recruitment

More information

Registered Nurse Educational Loan Guidelines

Registered Nurse Educational Loan Guidelines Registered Nurse Educational Loan Guidelines Wellmont enjoys a reputation for its outstanding commitment to the education and professional development of our caregivers. We invite you to apply for educational

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

YOUTH MENTORING PROGRAM. Mentee Application (To Be Completed by the Parent/Guardian)

YOUTH MENTORING PROGRAM. Mentee Application (To Be Completed by the Parent/Guardian) Personal Information YOUTH MENTORING PROGRAM Mentee Application (To Be Completed by the Parent/Guardian) Youth s Name: Date: Parent/Guardian Name: Relationship to Youth: Mother Father Other, specify: Street

More information

at the USC DAVIS SCHOOL OF GERONTOLOGY

at the USC DAVIS SCHOOL OF GERONTOLOGY = University of Southern California = INCLUDES Application instructions and forms for prospective Master s students. S U P P L E M E N T A L Application FOR THE Masters Programs at the USC DAVIS SCHOOL

More information

SAFE Employment Application

SAFE Employment Application SAFE Employment Application Name: Date: List names that you have worked under other than above: Mailing Home Position Desired: Salary Expected: Full Time: Part-time: Temporary: How were you referred to

More information

The 2015 Corpus Christi Catholic- Christian Community College Scholarship

The 2015 Corpus Christi Catholic- Christian Community College Scholarship The 2015 Corpus Christi Catholic- Christian Community College Scholarship The Scholarship The Corpus Christi College Scholarship (CCCS) is a merit- based financial aid grant awarded to an individual student

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

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

MASTER OF ARTS IN CRIMINAL JUSTICE GRADUATE ADMISSION APPLICATION. Date of Birth (MM/DD/YYYY)

MASTER OF ARTS IN CRIMINAL JUSTICE GRADUATE ADMISSION APPLICATION. Date of Birth (MM/DD/YYYY) 1450 SW Vintage Parkway, Suite 220 Ankeny, IA 50023 515-965-9355 www.simpson.edu/continue For office use only: Re-Admit Simpson ID Business Office Approved Denied Date: By: Perkins Loan Office Approved

More information

Eastern Michigan University Department of Psychology Clinical Behavioral Psychology M.S. Program (PSYB) Application Application Deadline: February 1

Eastern Michigan University Department of Psychology Clinical Behavioral Psychology M.S. Program (PSYB) Application Application Deadline: February 1 Eastern Michigan University Department of Psychology Clinical Behavioral Psychology M.S. Program (PSYB) Application Application Deadline: February 1 First Name: Middle Name: Last Name: Gender : Female

More information

MESA Community College Program (MCCP) Application

MESA Community College Program (MCCP) Application INSTRUCTIONS Complete this form as thoroughly as possible, and return with a copy of all your unofficial college transcripts; that is all colleges you have attended, and a copy of your student ID clearly

More information

Northern Kentucky University College of Health Professions and St. Elizabeth Healthcare

Northern Kentucky University College of Health Professions and St. Elizabeth Healthcare Northern Kentucky University College of Health Professions and St. Elizabeth Healthcare PATHWAYS TO NURSING SUMMER NURSE CAMP JUNE 25 th 28 th 2012 If you are a high school student who likes people, wants

More information

2016 Orientation Leader Application

2016 Orientation Leader Application 2016 Orientation Leader Application Thank you for your interest in the 2016 Orientation Leader Program. The Offices of Admission and Student Activities are excited you are considering this excellent leadership

More information

Leadership Program Application Packet

Leadership Program Application Packet 2013-2014 Leadership Program Application Packet ALL students interested in applying to the Leadership Program must complete and turn in the following: o A Photo of the Applicant (please attach to the front

More information

GREENSBORO HOUSING AUTHORITY EMPLOYMENT APPLICATION

GREENSBORO HOUSING AUTHORITY EMPLOYMENT APPLICATION GREENSBORO HOUSING AUTHORITY EMPLOYMENT APPLICATION GHA 1404 PLEASE ANSWER ALL QUESTIONS USING EITHER BLUE OR BLACK INK Position Applied For - You MUST be specific Date Available Expected Earnings Name

More information

School of Massage Therapy Fall 2016 Application Packet

School of Massage Therapy Fall 2016 Application Packet MT Professional & Community Education 4203 S. Providence Rd Columbia, MO 65203 Ph: 573-214-3803 Fax: 573-214-3811 Fall 2016 Application Packet Thank you for your interest in The Columbia Area Career Center.

More information

Social Work Department

Social Work Department Social Work Department BACHELOR OF SOCIAL WORK DEGREE PROGRAM Application For Admission Application Date Application for (Semester) (Year) Personal Information: Name Home Address City State ZIP Home Phone

More information

APPLICATION FOR EMPLOYMENT This application is active for 90 days.

APPLICATION FOR EMPLOYMENT This application is active for 90 days. Capital Manor is a smokefree workplace & campus. An Equal Opportunity Employer For Office Use Only: Date Received: APPLICATION FOR EMPLOYMENT This application is active for 90 days. Capital Manor will

More information

COMMUNITY COUNSELING CENTER Application For Employment

COMMUNITY COUNSELING CENTER Application For Employment 2801 C Court, Ashtabula, OH 44004 PHONE: (440) 998-4210 FAX: (440) 998-6489 COMMUNITY COUNSELING CENTER Application For Employment WEBSITE: www.cccohio.com We consider applicants for all positions without

More information

Program Description Program Goals: Application Deadline Application / Selection Process

Program Description Program Goals: Application Deadline Application / Selection Process Advanced Placement Magnet Application Chapel Hill High School (Application for the 2015-2016 School Year) Program Description: Chapel Hill High School is committed to expanding the Advanced Placement (AP)

More information

YMCA OF CENTRAL OHIO APPLICATION FOR EMPLOYMENT EVENING PHONE. OTHER NAMES USED DURING PRIOR EMPLOYMENT Maiden name, other surname, etc.

YMCA OF CENTRAL OHIO APPLICATION FOR EMPLOYMENT EVENING PHONE. OTHER NAMES USED DURING PRIOR EMPLOYMENT Maiden name, other surname, etc. YMCA OF CENTRAL OHIO APPLICATION FOR EMPLOYMENT The YMCA is an equal opportunity employer and does not discriminate or give preferential consideration because of sex, sexual orientation, gender identity,

More information

Annual Enrollment Application and Contract (For Preschool-age and older)

Annual Enrollment Application and Contract (For Preschool-age and older) Annual Enrollment Application and Contract (For Preschool-age and older) Child's Name: Date of Birth: Phone Number: City: State: Zip Code: Session (F)ull or (P)art Time Arrival Time Departure Time Rate

More information

2016-17 STANLEY BEHRENS FOUNDATION SCHOLARSHIP

2016-17 STANLEY BEHRENS FOUNDATION SCHOLARSHIP 2016-17 STANLEY BEHRENS FOUNDATION SCHOLARSHIP The Stanley Behrens Foundation Scholarship is awarded to an Orange County Community College Transfer Student who has demonstrated recognizable talents and

More information

NORTHWEST PARK & NATURE CENTER Junior Counselor Certification Program 2015

NORTHWEST PARK & NATURE CENTER Junior Counselor Certification Program 2015 Junior Counselor Certification Program 2015 The Junior Counselor Certification Program (JCCP) is a pre-counselor training program for youth ages 14-17, which focus upon gaining the skills necessary to

More information

Children s Hospital Colorado Medical Career Collaborative (MC 2 ) - Box 105 13123 E 16 th Ave Aurora, CO 80045

Children s Hospital Colorado Medical Career Collaborative (MC 2 ) - Box 105 13123 E 16 th Ave Aurora, CO 80045 Medical Career Collaborative 2016-2017 Application for All Sites Note to Applicants: Thank you for your application to the MC 2 program! Our team is proud to announce that we successfully embarked on an

More information

Scholarship Qualifications. Scholarship Application Requirements

Scholarship Qualifications. Scholarship Application Requirements Langley Federal Credit Union Jean M. Yokum Scholarship Program (2016 Graduating High School Senior) Langley Federal Credit Union offers four annual scholarships for each academic year.* Each $5,000 scholarship

More information

LBS II Certification Option Admissions Packet

LBS II Certification Option Admissions Packet LBS II Certification Option Admissions Packet We are pleased that you are interested in seeking the LBS II Certification Option in Special Education through the Department of Special Education at UIC.

More information

INFORMATION TECHNOLOGY INTERNSHIP

INFORMATION TECHNOLOGY INTERNSHIP INFORMATION TECHNOLOGY INTERNSHIP The City of Birmingham, Michigan, an equal opportunity employer, is seeking qualified candidates for an Information Technology (IT) Internship position. Under the general

More information

Name: Position Sought: GradYear: Martin Luther King HS Election Packet

Name: Position Sought: GradYear: Martin Luther King HS Election Packet Name: Position Sought: GradYear: Martin Luther King HS Election Packet Dear ASB Officer Applicant, Thank you for your interest in running for an Associated Student Body (ASB) position. Being on ASB is

More information

VOLUNTEER APPLICATION

VOLUNTEER APPLICATION CASA of Los Angeles Member National Court Appointed Special Advocate Association 201 Centre Plaza Drive Suite 1100 Monterey Park, California 91754 Phone 323-859-2888 Fax 323-264-5020 www.casala.org VOLUNTEER

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

MSU College of Nursing Accelerated Second Degree Program Supplemental Application, Instructions & Guidelines for Applicants Entering May, 2012

MSU College of Nursing Accelerated Second Degree Program Supplemental Application, Instructions & Guidelines for Applicants Entering May, 2012 MSU College of Nursing Accelerated Second Degree Program Supplemental Application, Instructions & Guidelines for Applicants Entering May, 2012 The deadline for receipt of application materials is December

More information

Athletic Training Program Practicum Phase Application

Athletic Training Program Practicum Phase Application Lincoln Memorial University School of Allied Health Sciences Department of Athletic Training Application Deadline: Monday, April 6, 2015 Athletic Training Program Practicum Phase Application PERSONAL DATA

More information

Provider Information Change Form I. PERSONAL INFORMATION

Provider Information Change Form I. PERSONAL INFORMATION Internal #: For Internal Use Only (Individual Application) Reason: New Provider Provider Information Change Form I. PERSONAL INFORMATION Name:.. First Middle Last Suffix Degree (MD,RN, etc.) Gender: M

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

Application for Admission

Application for Admission Application for Admission www.socialwork.dom.edu APPLICATION GUIDELINES The Graduate School of Social Work This packet includes a number of sections which must be completed, and it is the applicant s

More information

APPLICATION FOR ADMISSION TO CHICAGO-KENT COLLEGE OF LAW. Graduate Program in Taxation

APPLICATION FOR ADMISSION TO CHICAGO-KENT COLLEGE OF LAW. Graduate Program in Taxation 565 West Adams Street Chicago, IL 60661-3691 Tel 312 906 5360 Fax 312 906 5274 E-mail admit@kentlaw.edu http://www.kentlaw.edu APPLICATION FOR ADMISSION TO CHICAGO-KENT COLLEGE OF LAW APPLICATION PROCEDURE:

More information

SSI II: Advanced Principles of Molecular Biology and Neuroscience. 2016 Application Form

SSI II: Advanced Principles of Molecular Biology and Neuroscience. 2016 Application Form SSI II: Advanced Principles of Molecular Biology and Neuroscience 2016 Application Form PHOTO INSTRUCTIONS To be eligible for participation, applicants should: Currently be a high school Sophomore or higher

More information

2016 Scholarship and Internship Application Instructions

2016 Scholarship and Internship Application Instructions 2016 Scholarship and Internship Application Instructions A limited number of monetary and non-monetary awards are available for current students of the ACE Mentor Program of Chicago. Potential awards include

More information

UNIVERSITY OF PHOENIX SERVE IT FORWARD SCHOLARSHIP PROGRAM

UNIVERSITY OF PHOENIX SERVE IT FORWARD SCHOLARSHIP PROGRAM UNIVERSITY OF PHOENIX SERVE IT FOWARD SCHOLARSHIP University of Phoenix is pleased to be an official education partner of the HandsOn Network. Together, we will work to provide educational opportunities

More information