Junior Volunteer Application

Today's Date*

Name*

First Name

Last Name

Gender*

Male Female

Date of Birth*

Age*

Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Best Contact Number*

Text Message?*

Yes No

Email*

Name of Parent Guardian*

First Name

Last Name

School Attending

Enter full name

Year in school*

Sophomore Junior Senior None of the above

List organizations/groups you belong to (e.g. school, community etc.)*

1)... 2)... 3)... so forth

How did you hear about our program?*

Limit your response to 1 paragraph or less

Special talents, skills or interests?*

Limit your response to 1 paragraph or less

Please describe your previous volunteer experience, if any. *

Limit your response to 1 paragraph or less

What is/are your reason(s) for volunteering?

Limit your response to 2 paragraphs or less

Select all that apply. Time slots are not absolute. For example, if you are available from 2pm - 5pm, you can select 3pm - 6pm.

Other Times:

In an emergency notify*

Name, Telephone Number

I hereby certify that I have read and understood all statements and questions on this application and my responses are true and complete to the best of my knowledge. I understand that any false representation, misstatement or omission may be basis for immediate dismissal.*

Please type your initial above (e.g. if you are Joe Toogood, you type JT)

Rules and regulations

My services are donated to the hospital for humanitarian, religious or charitable reasons. I expect no payment, benefits or future employment. I do not expect to receive the minimum wage or overtime for my services. I will serve a minimum of 3 hours per week and commit to a schedule for at least 3 months.
I will serve a minimum of 1 year and for a minimum of 140 hours.
If unable to come in on my assigned day or time I will contact the Manager of Volunteers to inform and reschedule to make up the lost time. I understand that 3 unexcused absences is cause for terminating my membership as a volunteer. I also understand that failure to notify the department of an absence is considered unexcused absence.
I am willing to serve wherever I am needed at the hospital.
I understand that I will be taking orders and following directions from the Volunteer members, Junior Ambassadors, hospital personnel, Administration and other staff. (If you have difficulty doing this, you should reconsider serving as a volunteer)
I understand that only black pants or skirts and volunteer polo shirt along with RMC identification badge are to be worn while on duty and that my appearance will be neat and clean. If you are assigned to volunteer in a specific department, you may be assigned a different uniform.
I shall submit to examinations including TB screen, drug screening and blood test, as well as an annual flu shot that are necessary as part of my volunteer service. I authorize the person taking the tests to report the results to Regional Medical Center of San Jose. I shall also submit the required vaccination evidence including COVID booster, immunizations, and titers.
I shall be punctual, conscientious and endeavor to make my work and conduct professional in quality. I will attempt to resolve any problems related to my volunteer activities with the Manager of Volunteer Services.
I shall at all times uphold the philosophy and standards of the hospital.
I understand that the Volunteer Services Department reserves the right to terminate my volunteer status in their own sole discretion at any time.

Please read the rules and regulations above carefully. If accepted as a hospital volunteer, I agree that:*

I have read each of the above conditions and I agree to be bound by them I disagree

Junior Volunteer Application

On-boarding application deadlines are as follows:

How may I become a junior volunteer?

What do I do as a volunteer?

What do I receive from volunteering?

Thank You

Rules and regulations