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Junior Volunteer Application

Junior Volunteer Application

Prospective volunteers will be considered on qualifications and without discrimination because of race, color, religion, sex, national origin or disability.

Volunteer assignments will be discussed during the personal interviews.


Name:
Address:
City:
State:
Zip:
Phone:
Email address:
Date of birth:
   
Parents/Guardians  
Names:
Address:
City:
State:
Zip:
Phone:
Email Address:
   
Additional Information
School attending this fall:
Classification:
School, community and/or church activities:
Hobbies and skills:
Are you interested in a medical career?

If yes, which one?
 
Why do you want to be a Junior Volunteer?
 
Please list any relatives employed at Hendrick Medical Center and their relationship to you.
 
Please list any previous volunteer experience including the name of the organization, organization's address and duties performed.
   
Please list two references. (Exclude relatives and minors.)
Name:
Address:
Phone:
 
Name:
Address:
Phone:
   
Volunteer Services
Hendrick Medical Center
325.670.2317
1900 Pine St.

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