Hello! This application is ONLY for students in Fayette County Public Schools who enrolled in a COMMUNITY SERVICE CLASS and are previously approved by Mr. Greg O'Bryan with PLD High School. Please submit your completed application
as soon as possible. All students will be interviewed before acceptance for placement. We are accepting applications from August 1st thru September 1st of the current school year. Thank you.

Student Contact Information

NOTE: Please enter your cell number for your primary phone number.

Student Parent Contact Information

Emergency Contact*

*Complete this section only if someone other than your parent is your Emergency Contact.

Student Personal Information

Please select "Current School Year" you are enrolled in at the time of submitting this application.

Community Service 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 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.