Welcome to the Volunteer Services Department of Children's Hospital

Children's Hospital Volunteer Applicaton


Application date
Check which one applies to you:
First name
Middle name
Family/last name
DOB
Gender
Address Line 1
Address Line 2
City
State
Zip/postal
Phone (Home)
Phone (Mobile)
Phone (Business)
E-mail
Current Employer
Donation Matching Program
Current student
Current school/institution
Highest level of education completed
Describe your reasons for choosing to volunteer at Children's Hospital.
Availability
Monday 9 AM - 12 PM
Monday 1 - 4 PM
Monday 5 - 8 PM
Tuesday 9 AM - 12 PM
Tuesday 1 - 4 PM
Tuesday 5 - 8 PM
Wednesday 9AM - 12PM
Wednesday 1 - 4 PM
Wednesday 5 - 8 PM
Thursday 9 AM - 12 PM
Thursday 1 - 4 PM
Thursday 5 - 8 PM
Friday 9 AM - 12 PM
Friday 1 - 4 PM
Friday 5 - 8 PM
Saturday 9 AM - 12 PM
Saturday 1 - 4 PM
Saturday 5 - 8 PM
Sunday 9 AM - 12 PM
Sunday 1 - 4 PM
Sunday 5 - 8 PM
Are you required to volunteer, shadow or perform community service?
If yes, by whom?
How many hours?
When do the hours need to be completed?
Describe the volunteer experience(s) you've had, especially your experience with children.
What would you like to do as a Children's Hospital volunteer?
Is there anything else you would like for us to know?
Emergency Contact
In case you become sick or injured while volunteering, please list the emergency contact information for the person you want notified.
Contact name
Relationship
Address Line 1
Address Line 2
City
State
Zip/postal
Phone (Home)
Phone (Mobile)
E-mail
Health Requirements
    1. Proof of positive blood titers for the measles, mumps, rubella and chicken pox (MMR/Varicella titer test) If your titer test reveals that you don't have immunity to all 4 diseases then you will need to get another immunization from your own health care provider and provide us with that documentation.
    2. Proof of a current TB test (TB tests are required annually)
    3. Proof of Annual Flu Vaccination (Flu vaccine)
Background Check
Adults (18 years and older) will be required to fill out a background authorization form at the time of their interview granting Children's Hospital permission to perform a background check.
Confidentiality Agreement & Photo Release
I understand and agree that in the performance of my duties as a volunteer of Children's Hospital Health Care System I must hold in strictest confidence any observations I may make or information I may hear regarding patients, patient families or staff.

I verify that the information provided by me on this application is true, correct and complete. I attest that I haven't ever been arrested or charged with any crime and grant Children's Hospital permission to verify this information in arriving at a decision.

I understand that any false or misleading statements or the omission of any information necessary to make this application complete will result in refection of my application or termination of my service.

Additionally, Children's Hospital has my consent to photograph, video tape, or audio tape me performing my volunteer duties. I understand that these may be used toward the advancement of public education, the promotion of Children's Hospital, and/or any other legitimate purpose.

I understand that upon my successful completion of the volunteer placement processes required at Children's Hospital, I will become a volunteer. As a volunteer, I acknowledge that I will not receive compensation for services.
Confidentiality Agreement & Photo Release Agreement