Please complete this application form if you are between ages of 14 to 18 years old and are interested in becoming a Kootenai Health volunteer.

We improve health one patient at a time in a friendly and professional culture committed to superior quality and safety. Our volunteers play a large role in delivering quality services, by serving in a variety of ways throughout the hospital. Our volunteers must possess self-motivation and reliability.

We greatly appreciate your interest in volunteering at Kootenai Health. Before submitting this application, please read the information below.

We are very fortunate to have many individuals interested in volunteering and sometimes more than we have service openings for. The volunteer role is extremely important as everyone representing Kootenai Health has an impact on our patients and their experience with us. A few items to keep in mind:

• Volunteering is not job shadowing.

• We do not offer internships through our volunteer program.

• We cannot create a position based on personal or professional goals. We have specific volunteer roles that enhance the services we provide.

• Before applying, please ask yourself, “Am I applying because I have a sincere drive to help?” and “Can I consistently commit to volunteering each week?

Once you complete the form, click the "CONTINUE" button at the bottom.

Contact Information

First name:

Last name:

Middle name:

Nickname:

Street 1:

City:

State:

* Zip: *

Home phone:

Cell phone:

Email address:

Emergency Contact

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First name:

Last name:

Street 1:

City:

State:

Zip:

Home phone:

Work phone:

Cell phone:

Email address:

Relationship:

Tell us about yourself

Why do you want to volunteer at Kootenai Health?

How did you hear about us?

How did you hear about our volunteer program?

Do you have a friend who is currently with us?

If you have a friend who is currently a Kootenai Health volunteer would you be willing to provide us with their name?

Educational History

Please list the high school you attend, the last grade you completed, as well as the year you will graduate:

Additional Information

Please provide us with additional information that you feel will help us get to know you better:

PLEASE READ AND Check the Box

• I hereby express my desire to volunteer for Kootenai Health.

• I am aware that, if accepted, I will be expected to be prompt and to perform my duties conscientiously, and to find a fellow teen volunteer to substitute for me if I am unable to report for my scheduled shift.

• I understand that any falsification of information on this application may result in immediate termination of the application/on-boarding process or as a volunteer with Kootenai Health.

• I understand that a volunteer is expected to observe confidentiality with respect to all patient information at all times, and that failure to do so may result in my personal liability to the patient and/or the hospital.

Flu Vaccination Policy: In the spirit of safeguarding patients – as well as you, our employees, faculty, physicians, staff, students and volunteers – a mandatory flu vaccination policy has been implemented across Kootenai Health.

I understand that, if accepted, that Kootenai Health volunteers are required to receive an annual flu vaccination. Individuals with severe reactions to any component of the flu vaccine, other than egg proteins, must provide written documentation from their primary care physician stating such.

I Agree