SGMC Canopy of Care Teen Volunteer Application

THANK YOU FOR YOUR INTEREST AND MAKING THE TIME TO APPLY TO OUR ORGANIZATION. UNFORTUNATELY, DUE TO COVID-19 CIRCUMSTANCES, WE ARE UNABLE TO MOVE FORWARD WITH OUR SUMMER CANOPY OF CARE PROGRAM THIS YEAR. WE HOPE THAT YOU WILL CONSIDER DONATING YOUR TIME WITH US NEXT SUMMER 2022. UNTIL THEN, PLEASE STAY SAFE.



Name and address

Please thoroughly complete this section as it is the primary information used in identifying you as a volunteer.



Demographic Information

This information is used to validate your age for qualification purposes.



Screening Questions

Please provide your best response to the following question:



Availability

Canopy of Care placements are only assigned Monday through Friday from 7:30a-1:30p, 8:30a-2:30p, 9:30a-3:30p, 10:30a-4:30p. Based on this please indicate the days and times that would be the closest fit to your availability to volunteer. Note that for our Canopy of Care initiative, your schedule flexibility could dictate your ability to be placed. We recognize that most applicants have other extra curricula summer commitments however, we establish the placement schedules to allow for the maximum coverage for each department.


Note, due to the need for onsite assistance of supervision by Volunteer Services, all placements are limited to the Main SGMC Campus only. Examples of areas for possible placement include:


Administration Clerical Support, Employee Health Clerical Support, Marketing/Public Relations, Patient Access Services, Emergency Department, Engineering, Food Services (Cafeteria/All Spice), Nutrition/Dietician Services, Golden Galleria Gift Shop, Imaging Center, Information Technology (IT), Labor and Delivery, Post Partum, Pediatrics, Medical/Surgical Nursing Unit, Outpatient, Post Anesthesia Care Unit (PACU), Extender, Pearlman Cancer Center Clerical Support, Pearlman Cancer Center Lab, Sterile Processing (OR), Surgical Services (OR), Therapy Rehab, Cardiac Rehab, In-patient Rehab.


*** The following schedule times: 7:30a-1:30p, 8:30a-2:30p, 9:30a-3:30p, 10:30a-4:30p Monday through Friday are the correct Canopy of Care scheduling times. We apologize for any confusion.***



Screening Questions

Please provide your best response to the following question:



Screening Questions

Please provide your best response to the following question:



Screening Questions

Please provide your best response to the following question:



Emergency Contact

Please enter a primary emergency contact that can be reached during your volunteer service hours along with their relation to you (i.e. parent, sibling, etc.) Please also include their number to contact them.



Parental/Guardian Consent

Please confirm your parental/guardian consent by typing your parent/guardian(s)full name(s) and daytime contact information to include phone number and email address. Parents will be contacted prior to scheduling screening appointments to confirm their consent.



Reference

Please provide the name and contact information of one adult reference that you will be providing as part of your application. Your reference will complete a "character sheet" that you will submit with your final paperwork. This should be someone other than a family member (i.e. school counselor, teacher, church member) that is willing to write a statement about your character.



Certification of Applicant

As a Canopy of Care Volunteer applicant I understand that I am required to:

1. Be a student between the ages of 14 and 17

2. Provide documentation of a B grade point average

3. Have written consent from a parent or guardian

4. Submit a referral from a school counselor or teacher at the time of my screening or prior to orientation if a returning Canopy of Care Volunteer

5. Read the youth volunteer handbook

6. Confirm a screening appointment if a first year volunteer

7. Fill out the Canopy of Care Volunteer health report and return to Volunteer Services

8. Attend the Canopy of Care Volunteer Orientation

9. Follow the hospital rules and regulations outlined in the handbook and Canopy of Care Volunteer Orientation

10. Volunteer the entire 7-week program, two days per week as scheduled, with no more than 3 days of pre-scheduled absences (Absences must be mentioned prior to Orientation to be considered "pre-scheduled". Due to the entrance demand of the program, any non-scheduled absences or absences exceeding the allowed amount, will result in dismissal)

11. Contact Volunteer Services IMMEDIATELY regarding any absences from duty or need to decline your placement. Failure to do so will result in termination from the Canopy of Care Volunteer initiative and may prevent future acceptance.


I understand the hours that I serve as a volunteer for South Georgia Medical Center are without promise, expectation, or receipt of compensation for service rendered. I also further understand that I will not expect to be hired for a paid position in the future, solely based on the fact that I was a volunteer for SGMC. Volunteer Services is not obligated to provide a volunteer position, nor are you obligated to accept the volunteer position offered. Opportunities for volunteers are provided without regard to religion, creed, race, national origin, age or sex.