STUDENT VOLUNTEER PROGRAM COLLEGE STUDENT Application Packet Part 2
INSTRUCTIONS FOR APPLYING Application Procedural Steps: 1. Complete pages 2-7 and sign the Application 2. Distribute and have returned to you: a. LETTER OF REFERENCE FORM (Pages 5 & 6) to two (2) school employees (any paid teacher, coach, guidance/career counselor, school counselor, etc.). b. DOCUMENTATION OF GPA (Page 7) form to your school counselor. After The Online Application is Complete: We will confirm receipt of your online application and arrange an opportunity for you to come in for an interview. For any questions regarding these forms or procedures, please contact Maria Fisher, Volunteer Specialist, at 585-922-2927. 1
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ESSAY OF INTENT I, (Name), am applying for the Student Volunteer program with the Rochester Regional Health. Below (or stapled to this Essay of Intent ) is my brief and to-the-point 150-200 word essay explaining why I want to participate as a student in the Volunteer program. My signature below verifies the following: I understand that writing and submitting this Essay does not guarantee that I will be accepted into the Volunteer Internship program. I understand that this Essay is an important part of the application process because it expresses how the Volunteer will help me attain my personal goals. The thoughts and words written below are my own and were not plagiarized, dictated, or written by someone other than me. Student Signature Date 4
This form may be faxed to Volunteer Office at Rochester General Hospital. Fax#: 585-922-2095 LETTER OF REFERENCE FORM (To Be Completed by a School Employee ) Reference #1 of 2 (Name) has applied for the Rochester Regional Health Student Volunteer Program. To get to know the applicant better and make an informed decision about the applicant s ability to volunteer, please complete the following letter of reference as soon as possible and return to the applying student. Your Name: Address: (Street) (City) (Zip Code) How long have you personally known the applicant: How well do you know the applicant? Very Well Well Casually Other Please check the following: Qualities/Characteristics Excellent Good Fair Poor Attendance/Promptness Courteousness Dependability Follows instructions Maturity Shows Initiative Trustworthiness Works well with adults Works well with peers Comments: (use reverse side if needed) Signature of Reference: Date Print Name of Reference: Title: School School Employee refers to any paid teacher/professor, coach, career counselor, school counselor, etc. 5
This form may be faxed to Volunteer Office at Rochester General Hospital. Fax#: 585-922-2095 LETTER OF REFERENCE FORM (To Be Completed by a School Employee ) Reference #2 of 2 (Name) has applied for the Rochester Regional Health Student Volunteer Program. To get to know the applicant better and make an informed decision about the applicant s ability to volunteer, please complete the following letter of reference as soon as possible and return to the applying student. Your Name: Address: (Street) (City) (Zip Code) How long have you personally known the applicant: How well do you know the applicant? Very Well Well Casually Other Please check the following: Qualities/Characteristics Excellent Good Fair Poor Attendance/Promptness Courteousness Dependability Follows instructions Maturity Shows Initiative Trustworthiness Works well with adults Works well with peers Comments: (use reverse side if needed) Signature of Reference: Date Print Name of Reference: Title: School School Employee refers to any paid teacher/professor, coach, career counselor, school counselor, etc. 6
This form may be faxed to Volunteer Office at Rochester General Hospital. Fax#: 585-922-2095 Dear Registrar, DOCUMENTATION OF GPA (To Be Completed by the College/University Registrar) (Name) has applied for the Rochester Regional Health Student Volunteer program. A core requirement for students to participate in our Student Volunteer program is a cumulative B GPA or higher. Please complete the following information as soon as possible and return to the applying student. Your Name: Your Title/Position: REGISTRAR School: Daytime Phone: ( ) I hereby verify that the above-mentioned student s cumulative GPA is. Signature of Registrar: Date: Thank you kindly for assisting this student in his/her process of being considered for placement with the Rochester Regional Health Volunteer Program. If you have any questions, please contact Maria, Fisher, Volunteer Specialist, at 585-922-2927. 7