Hello and "Thank You" for your interest in the COLLEGE VOLUNTEEER opportunities at Baptist Health Lexington. Please note, opportunities are extremely limited. If accepted, all college volunteers must be able to commit to 50 hours minimum of service. Please complete this application.

Student Contact Information

First name:

Last name:

Street 1:

Street 2:

City:

State:

* Zip: *

Primary phone:

Email address:

Please list any family member names who are employed here at Baptist Health Lexington.

Emergency Contact Information

First name:

Last name:

Cell phone:

Email address:

Relationship:

Student Personal Information

Please indicate the days and times you are usually available to volunteer.

Date of birth:

Age:

Gender:

Shirt/Uniform Size:

Current School Year:

Assignment Preference:

1st choice:

2nd choice:

3rd choice:

Why do you want to volunteer here at Baptist Health Lexington?

Student Volunteer/Work Experience

Please list any previous volunteer and/or work experience.

Student References

First name:

Last name:

Cell phone:

Email address:

Relationship:

Program Information

How did you find out about our College Volunteer Program?

Student Special Skills

Please list any specifics relative to your skills which may aide us in determining an assignment for you. Some examples--Working on an art degree and can share their skills with our patients OR state what instrument the student plays violin, guitar, or harp OR singing OR proficient computer skills, OR bilingual OR culinary etc.)

College Student Agreement

By submitting this application, I am agreeing to the following if I am selected:

Abide by Baptist Health Lexington Hospital's policies and procedures.

Volunteer for a minimum of 50 hours.

Volunteer in my assigned area of the hospital.

Follow Baptist Health Lexington's Dress Code requirements found in student's orientation packet.

Follow Baptist Health Lexington's handwashing guidelines and our other sanitation procedures.

Maintain the highest level of confidentiality when discussing patient and other hospital matters ONLY as it relates to my volunteer/observation assignment duties.

I Agree