This application is for the West O`ahu location only.


Please complete this application if you are over the age of 15 years and under the age of 18 years, able to commit to at least 64 hours of volunteer service, and are enthusiastic about volunteering at The Queen's Medical Center - West O`ahu.


Be sure to complete each section of the application form. Once complete, click the "Continue" button.


Note: This form may not automatically reformat for your mobile device.



NAME AND ADDRESS


DEMOGRAPHIC INFORMATION

This information is used to help us get a better idea of the demographic make-up of our volunteers.



PARENT OR GUARDIAN


THE QUEEN'S MEDICAL CENTER

If you are currently employed, have been employed or have volunteered at The Queen's Medical Center, The Queen's Medical Center West O`ahu, North Hawaii Community Hospital or one of The Queen's Health Systems companies, please provide details in the box below.




VOLUNTEER EXPERIENCE

If you currently volunteer or have volunteered at other organizations, please detail when, where and your position or tasks in the box below.



CURRENT EMPLOYMENT


STUDENT

Use the drop down menu to select your school. If it does not appear, please enter the name of your school in the box below.



AVAILABILITY

Before selecting, please view the Volunteer Opportunity Directory. Copy and paste the following link into your browser: www.volgistics.com/ex/portal.dll/OD?FROM=12167.


Your schedule will be based on the information you provide.



SKILLS AND INTERESTS


EMERGENCY CONTACT

Whom should we contact if you become ill or injured while volunteering?



EMAIL PREFERENCES

We like to keep volunteers informed of important news, schedules, and volunteer opportunities by email, however will not send you any email you prefer not to receive. Use the checkboxes below to select the kinds of email you would like to receive from us.



Pledge

I am over the age of 15 years and understand that I will not receive remuneration for the volunteer service I provide.


I will commit to at least 64 hours of volunteer service.


I certify that the information I have provided in response to the questions on this application is true and correct. I understand that any false or misleading statements or omissions, whenever they are discovered, are grounds for disqualification from further consideration or for dismissal from volunteering.


The organization is not obliged to provide placement, nor are you obligated to accept the position offered.