PLEASE NOTE: Our Junior Volunteer Program is very popular. While we very much appreciate your interest and willingness to serve our patients, we want you to know that our wait-list is very long. Students applying now will most likely NOT be placed in our summer 2020 program and may or may not be placed in fall of 2020. All applicants are put on a wait-list and when we have an opening for the summer or school year program, we draw from that list. Many applicants wait up to two years and unfortunately, we cannot accept everybody who applies.

Please complete this application form if you are interested in the wait list to become a Winchester Hospital Junior Volunteer. Once you complete the form, click the submit button at the bottom.

Name and address

Please type parent/guardian's email address in secondary email field.

Personal Information

Please provide the following information. It is used only to help us get a better idea of the demographic make-up of our volunteers.

Parent & Emergency Contact Information

Please list a parent/guardian name, as well as another contact name in case of an emergency. The emergency contact should be the person who is most likely to be available during your volunteer shift.

School & Guidance Counselor Information

Please fill in your year of graduation from high school, school attending and the contact information for your guidance counselor.

How did you learn about volunteering at WH?

How did you learn about the Junior Volunteer Program at Winchester Hospital? Do you know any current volunteers?

Briefly explain why you want to be a volunteer.

Additionally, have you volunteered elsewhere?

Connection within the Winchester Hospital

Have members of your family volunteered at Winchester Hospital, or are they employees of Winchester Hospital? If yes, please list their name(s), your relationship to them, and the department(s) where they work.


Are you applying for our school-year program, our summer program, or both?


Do you have to commit to volunteer service hours? If yes, how many hours? Additionally, please list the organization, contact name, telephone number and mailing address of where you need to report these service hours.

Career Interests & Goals

Please share what your future career goals or occupational interests might be.