Thank you for your interest in volunteering for the COVID-19 Hope Squad with community vaccinations and at testing sites! 

Please complete this application form if you are interested in becoming a Wellspan Health COVID-19 Hope Squad Volunteer. Must be at least 16 years old to apply.

What Can You Expect When Volunteering with the COVID-19 Hope Squad?

  • Will have both clinical and non-clinical roles available
  • Required to stand for long periods of time
  • May be required to lift up to 15 pounds
  • May be required to work outside
  • Volunteers must commit to volunteer for a minimum of 5 five-hour shifts over a six month period (i.e. minimum of 25 hours over 6 months)
  • COVID-19 and its variants are widespread in our communities.  When Volunteers interact with others, Volunteers may be exposed to COVID-19 and its variants and understand the risks associated with volunteering with a healthcare organization.  
  • Volunteers will be required to obtain a PA Dept. of Human Services Child Abuse Clearance and a PA DHS FBI clearance (at the expense of Volunteer Engagement; instructions will be provided) within 60 days of starting as a COVID-19 Hope Squad Volunteer.   

Once you complete the form, click the submit button at the bottom.

PLEASE NOTE: Submitting an application does not guarantee acceptance into the Wellspan Health Volunteer Program. Your application will be reviewed and if initial qualifications are met, you will be contacted (via email) for next steps.


Applicant Information:

Please provide your full legal name (i.e. no nicknames).



How Can You Help?

We will have many different roles for Volunteers.

If you are interested in administering the vaccine and/or administering COVID-19 tests at collection sites, you must hold an active professional clinical license. Please list your specific license held (i.e. RN, MD, Pharmacist, etc.), state of issuance and license number below.

For those without active required licenses or no clinical experience, we'll have other non-clinical roles, such as registration, greeting, line control and way-finding to name just a few.



Epic User Experience

Do you have experience using Epic (WellSpan's electronic health record)? If yes, please provide details on the module(s) used?



Criminal Record Clearances

All Volunteers will be required to obtain criminal record clearances (at the expense of WellSpan Volunteer Engagement) within 60 days as becoming a COVID-19 Hope Squad Volunteer.  More details will be provided once an applicant is approved.    

Please provide details if you have a prior conviction, including the type of offense, date and county.



Emergency Contact:


Community Service Requirement:

Please provide information if you are volunteering to fulfill a community service requirement, including the name of the school/organization, number of hours needed and deadline for completion.



Volunteer T-Shirt Size

COVID-19 Hope Squad Volunteers will be provided with a T-shirt. Please list size needed.  NOTE:  While Supplies Last.  



Volunteers Under the Age of 18 (minimum age = 16):

If Volunteer applicant is 16 or 17, parent/guardian understanding of the following is required:

1. Gives permission for child to serve as a COVID-19 Hope Squad Volunteer.

2. Importance of child's punctuality and reliability.

3. Supports child's commitment to volunteerism.

4. Affirms the application is true and accurate.

5. Permits the use of child's photograph as a volunteer to be used for publicity purposes.

6. Understands that if child does not follow policies and procedures of Wellspan Health/Volunteer Engagement or does not present for scheduled volunteer shifts, child will be terminated.



If 16 or 17, Enter Parent/Guardian Information:


Agreement:

I hereby certify that all statements and answers set forth on the application are true and complete to the best of my knowledge. I understand that any statements and/or answers are found false or information has been omitted, may be cause for rejection or termination of my volunteer application or service. I understand that a condition of volunteering, WellSpan will request a background check consisting of a criminal history check. I understand that my consent will apply throughout my volunteer services with Wellspan to the extent permitted by law. I permit WellSpan Health to use my name, photograph or video as a volunteer for publicity purposes when necessary.  I understand that COVID-19 and its variants are widespread in our communities and I may be exposed and understand the risks associated with volunteering with a healthcare organization.