Page 1

Junior Volunteer Program

at Geneva General Hospital Summer 2014

Finger Lakes Health welcomes young people, ages 14-17, to participate in our Summer Junior Volunteer Program. The experience is personally rewarding, and it helps students to make career and educational choices that may guide their lives. In addition, documentation of the volunteer hours adds credibility to college and job applications. Junior Volunteers are chosen based on an application process, and then volunteer assignments are made on a first-come, first-served basis. We will make every effort to find a position that fits the student. Become a Junior Volunteer Volunteering at Finger Lakes Health can be a very rewarding experience. In addition to the satisfaction you receive from helping others, you may also gain insights into the medical field as a possible profession. Through this program, Junior Volunteers gain experience for future employment as well as exposure to the healthcare field and the professionals that work within this exciting environment. As a Junior Volunteer, you will: • Be asked to serve at least 25 hours between July 7 and August 22. • Attend a mandatory orientation session in June. Requirements to apply: • You must be between the ages of 14 and 17 years old. • Submit the Junior Volunteer application. • Submit two letters of recommendation. If accepted as a Junior Volunteer, you will be required to: • Submit a copy of your physical from the 2013-2014 school year. If you do not have this, you may have a physical done at the Seneca Family Health Center in Waterloo, free of charge. • Submit a copy of your immunization record. • Submit proof of TST (Tuberculin Skin Test) results. If you have not had a TST in the past year, you may have one done at our Employee Health Office, free of charge. • Follow the Finger Lakes Health Professional Dress Standards policy. Junior Volunteer responsibilities might include: • Providing clerical assistance in medical office areas. • Running errands throughout the health system. • Participating in activities and one-on-one sessions in our Living Centers (nursing homes). • Being an assistant in our Child Care Center. • Helping medical staff as needed

Deadline for application submission is May 23, 2014


Deadline for application submission is May 23, 2014

Junior Volunteer Application (14-17 Years) Name (please print): __________________________________________ Date ___________________ Address: ____________________________________________________________________________ City: ______________________

Zip: ___________

Date of Birth: _________________

Phone Number: ______________________

E-Mail Address: _____________________________________

Overall Health Condition / Physical Limitations:

____________________________________________

School Name: ________________________________ Grade Level in Fall of 2014: _________________ Previous Volunteer Experience: ___________________________________________________________ Important: If you were a Junior Volunteer with Finger Lakes Health in previous years, you may be considered for the program only if the spots are not filled by first-time applicants. We will accept your application and notify you if spots are still available after the May 23 application deadline. Please rank your top 3 areas of volunteer interest (we will make every effort to accommodate your request, but depending on the amount of applicants we receive, we cannot guarantee your top choice):

Child Care Center Helper

Physical/Occupational Therapy Helper

Living Center (Nursing Home) Helper

Marketing Office Helper

Radiology/Cardiopulmonary Helper

Any Open Position is Fine with Me

Joint Center Helper

Have you ever committed, been convicted of, pled guilty to, or pled nolo contendo to a felony or a misdemeanor? (NOTE: Conviction of a crime is not necessarily grounds for disqualification.) q Yes q No If yes, please explain: ___________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ Continued on next page


Deadline for application submission is May 23, 2014

Please note the days and times you are available to volunteer:

July: Monday

Tuesday

Wednesday

Thursday

Friday

Tuesday

Wednesday

Thursday

Friday

August: Monday

IN CASE OF EMERGENCY, PLEASE NOTIFY: Name: _____________________________________________________________________________ Address: ___________________________________________________________________________ City: ______________________________________ State: _____________ Zip: ________________ Daytime Telephone: ___________________________________________________________________ Relationship to Junior Volunteer:

____________________________________________________

__________________________________________ ________________________________ Volunteer’s Signature Date __________________________________________ ____________________________________ Parent/Guardian Signature Date __________________________________________ ____________________________________ Finger Lakes Health Staff Signature Date Return all required paperwork and/or direct any questions about the Junior Volunteer Program to: Geneva General Hospital Christen Smith, Community Outreach Coordinator 196 North Street, Geneva, NY 14456 Phone: (315) 787-4065 ~ Fax: (315) 787-4063 ~ E-mail: christen.smith@flhealth.org


Junior Volunteer Program

at Geneva General Hospital Letter of Recommendation (1) Please attach this completed form to student’s letter of recommendation

Student Volunteer: ____________________________________ Date: _____________ Student’s School: _____________________________________

Age: ______________

Letter of Recommendation written by: _______________________________________ Title: _____________________________________________________________________ Address: __________________________________________________________________ Daytime Telephone: ________________________________________________________ Relationship to Student: ____________________________________________________ Because many departments ask volunteers to work independently on specific projects, and because confidentiality is paramount in all areas of the facility, we make every effort to place junior volunteers in appropriate areas. Interested teenagers must obtain two written references recommending them for a volunteer position at Geneva General. References can come from a teacher, pastor, guidance counselor, family friend, etc. Written references should focus upon the applicant’s reliability, ability to work independently, and proficiency in handling responsibility. Thank you for your time.

Deadline for application submission is May 23, 2014 Please return this form and your letter of recommendation to: Geneva General Hospital Christen Smith, Community Outreach Coordinator 196 North Street Geneva, NY 14456 Phone: (315) 787-4065 ~ Fax: (315) 787-4063 ~ E-mail: christen.smith@flhealth.org

www.flhealth.org


Junior Volunteer Program

at Geneva General Hospital Letter of Recommendation (2) Please attach this completed form to student’s letter of recommendation

Student Volunteer: ____________________________________ Date: _____________ Student’s School: _____________________________________

Age: ______________

Letter of Recommendation written by: _______________________________________ Title: _____________________________________________________________________ Address: __________________________________________________________________ Daytime Telephone: ________________________________________________________ Relationship to Student: ____________________________________________________ Because many departments ask volunteers to work independently on specific projects, and because confidentiality is paramount in all areas of the facility, we make every effort to place junior volunteers in appropriate areas. Interested teenagers must obtain two written references recommending them for a volunteer position at Geneva General. References can come from a teacher, pastor, guidance counselor, family friend, etc. Written references should focus upon the applicant’s reliability, ability to work independently, and proficiency in handling responsibility. Thank you for your time.

Deadline for application submission is May 23, 2014 Please return this form and your letter of recommendation to: Geneva General Hospital Christen Smith, Community Outreach Coordinator 196 North Street Geneva, NY 14456 Phone: (315) 787-4065 ~ Fax: (315) 787-4063 ~ E-mail: christen.smith@flhealth.org

www.flhealth.org

2014 junior volunteer application