Summer Junior Volunteer Program 2016 Information Packet Volunteer Services February1,2016 Dear Prospective Junior Volunteer: Thank you for your interest in the2016junior Volunteer Program at Baylor Scott & White Medical Center - Grapevine. The summer Junior Volunteer Program is a competitive program for studentsentering 11 th - 12 th grades in the fall of 2016 (ages 15-18)that have an interest in a career in healthcare and who have not previously participated in the program. Baylor Scott & White - Grapevine will offer two 4-week junior volunteer sessions. Each session will be 5 days a week, Monday Friday, 4 hours a day for four weeks. There are two shifts available: Mornings, 8:00 a.m. 12:00 p.m. and Afternoons, 1:00 p.m. 5:00 p.m. You will be expected to volunteer every day for those four weeks. Do not apply to the program if you are unable to commit to a full session 5 days a week for 4 weeks (80 hours). Session A begins Monday, June 6 through Friday, July 1 Session B begins Monday, July 11 through Friday, August 5 We understand that many of you have busy schedules during the summer and,given the fact that we have a limited number of slots available, we ask that youconsider whether a commitment for the entire Junior Volunteer Program is something you will be able to fulfill. All applicants are welcome to apply. In addition to targeting students with an interest in healthcare, we give preference to children/grandchildren of Baylor Scott & White - Grapevine employees, volunteers, and affiliated physicians. Please be aware that this is not a job shadowing program.as we strive to meet the needs of the hospital, all junior volunteers will be assigned to the Guest Relations role. Application Requirements Items 1 through 5 below must be received in the VolunteerOffice in acomplete packet no later than 5 p.m. on Friday, March 4, 2016.Please send completed applications to Maureen Hair, Manager, Volunteer Services,,. Incomplete packets will not be processed. 1. The completed Application. 2. The completed Medical Authorization Form. 3. Copy of your Immunization Record including documentation for the following vaccinations: a. TB test (done and read) within the past 12 months b. MMR x 2 c. TDAP d. Varicella x 2 e. Hepatitis x 3 1
4. One (1) non-family member recommendation.this should be written by someone who can attest to your work ethic. 5. In a one-page, single spaced, typed essay, please answer the following1) why did you choose to volunteer in Baylor Scott & White - Grapevine s Junior Volunteer Program; 2) what do you expect to gain from the experience; 3) what are your career goals; 4) how do you think this volunteer experience will help you achieve these goals; and 5) what can you bring to the program that makes you stand out from the other applicants. Acceptance into the Junior Volunteer Program If you are accepted into the program, you will receive notice of your acceptance into the program via emailonmonday, April 4 th. That email will provide additional detailed information regarding the next steps in the process. Junior volunteers accepted into the program will be required to successfully pass a background check and drug screen.additional information and paperwork will be provided at the orientation session. Junior volunteers accepted into the program will be required to purchase their uniform shirt for a nominal fee of $10 fee. Every junior volunteer and one parent/guardian must attend a MANDATORY orientation. The orientation sessions are Wednesday May 18, 2016, from 6 p.m. 9 p.m. or Saturday May 21, 2016from 9 a.m. 12:00 p.m. These sessions will be held in the Center for Continuing Education(CCE) which is located in Tower 2, 1 st Floor.If you and your parent/guardian do not attend one of the MANDATORY sessions, you will be removed from the program. Completion of this application does not guarantee acceptance in the program. Decisions of Volunteer Services are final. Respectfully, Maureen Hair, Manager 817-329-2665 2
JUNIOR VOLUNTEER APPLICATION Name: Address: Last First Adult T-Shirt Size Street Name City Zip Cell Phone Home Phone E-Mail Address Age Birthday (m/d/y) Student ID Number School Attending in Fall 2016 Grade Fall 2016 Parent (or Guardian) Name: Emergency Contact: Name Relationship Phone Number Do you use any type of nicotine products? Yes No Extracurricular Activities: Work/Employment Experience: Are you related to a Baylor Scott & White - Grapevine staff member, affiliated physician or volunteer? If yes, please provide name of relative Yes No IDENTIFY YOUR FIRST, SECOND, THIRD AND FOURTH SESSION SELECTIONS BY ENTERING THE NUMBER 1, 2 3 AND 4 ON THE LINE BESIDE YOUR CHOICES SESSION A: June 6 July 1 8:00 a.m. to 12:00 p.m. 1:00 p.m. to 5:00 p.m. SESSION B: July 11 August 5 8:00 a.m. to 12:00 p.m. 1:00 p.m. to 5:00 p.m. MANDATORY ORIENTATION Please select one: Wednesday, May 18, 2016 Saturday, May 21, 2016 6 9 p.m. 9 a.m. noon 3
JUNIOR VOLUNTEER APPLICATION (continued) I certify that the information given by me in this application is true in all respects. I understand that if any information is found false, I may be subject to dismissal without notice. I authorize past employers and all references to answer all questions asked by the hospital concerning my ability, character, reputation, and previous employment record. I release all such persons from any liability or damages. If accepted as a Junior Volunteer, I further agree to work faithfully and diligently, to be careful and avoid accidents, to come to work promptly, and to notify my manager about any changes in my schedule. I agree to abide by all policies and rules of Baylor Scott & White - Grapevine. Junior Volunteer Signature: Date: PARENTAL PERMISSION I,, give permission for to (parent or legal guardian) (student) participate as a Junior Volunteer at Baylor Scott & White - Grapevine. Parent Signature: Date: 4
JUNIOR VOLUNTEER PROGRAM Medical Authorization Form The following is needed in case your child becomes ill or is injured while volunteering in the hospital as a junior volunteer. This information will be held in highest confidence. I,, parent of give authorization for EMERGENCY medical attention in Baylor Scott & White Grapevine s Emergency Room and authorize the following persons to be contacted in the event of illness or an accident while my child is volunteering as a junior volunteer. 1. 2. PHYSICIAN TO BE CONTACTED: Please give us any additional information we might need to know in case of an emergency Parent or Legal Guardian Signature: Date 5