Please complete this application form in its entirety to begin the process of becoming a WellStar Cobb

Hospital VolunTeen. Once you have completed the form, click the Continue button at the bottom of the

page.

COLLEGE STUDENTS

If you are a college student seeking summer volunteer opportunities please visit our regular volunteer webpage for people age 18 and older located at https://www.wellstar.org/about-us/volunteers/pages/wellstar-cobb-hospital-volunteers.aspx. Note that you must complete the application and onboarding process by May 31 to be eligible to volunteer as a summer college student.

Personal Information

First name:

Last name:

Middle name:

Preferred Name:

Street 1:

Street 2:

City:

State:

* Zip: *

Home phone:

OK to call me here

Cell phone:

Email address:

Date of birth:

Uniform size:

High School:

Current Grade Level:

Emergency Contact

In the event of an emergency whom should we notify? (Typically should be a parent/legal guardian)

First name:

Last name:

Home phone:

Work phone:

Cell phone:

Email address:

Relationship:

Relatives

Please list any relatives that are employed by WellStar and their departments.

Why I Want to Volunteer

This essay is a requirement, and your application will not be considered if this section is not completed.

100-150 word essay on why you want to be a part of the Virtual VolunTeen Program and why we should consider you for admission.

Please note:

A copy of your most recent report card is required to complete your application. Please email to cobbvolunteers@wellstar.org or mail to

Cobb Volunteer Services

ATTN: Nathan Causey

3950 Austell Road

Austell GA 30106

Interview

We expect to receive a high number of applications. Applicants selected to move forward in the process will be contacted regarding a virtual interview. Not all applicants will move forward to this step. Following the interviews, you will be notified by May 5, 2023, of your acceptance/decline to the program.

To become a VolunTeen, I understand that I MUST

* Be a student between the ages of 16-18. Must be age 16 by May 31st.

* Submit a copy of your most recent report card

* Maintain a 3.0 GPA (B).

* Submit a 100-150 word essay.

* Participate in all 5 sessions of the program.

I Agree