Please complete this application form if you are interested in becoming a volunteer at East Tennessee Children's Hospital.


This form is for individuals who are 18 years of age and older. If you are 18 years old and still in high school, you are not eligible to apply.


Please Note:

-All volunteers are required to receive a flu vaccination when volunteering during the months of November through April.

-All volunteers are required to commit to a weekly four-hour shift for at least six months.

-All volunteers are required to submit MMR vaccination records.


Once you complete the form, click "Continue" at the bottom.


Personal Information


Medical

Please list your physician and check if you are not willing to have a flu shot. (Children's Hospital Volunteers are required to have a flu vaccine when volunteering during the months of November through April.)



Emergency Contacts

Please list two emergency contacts.



Availability

Please check the days and specific shifts you are currently available for a volunteer assignment.Typical shifts: Morning: 8:30 am - 12:30 pm, Afternoon: 12:30 - 4:30 pm, Evening:4:30 - 8:30 pm (You will be expected to volunteer weekly for 6 months and we will work with you if your schedule should change.)



Children's Hospital Relationships

Please list any family or friends who either work or volunteer at the hospital.



Volunteer Interests


Work Experience / Skills


Volunteer Experience


References

List the names of two people, other than relatives, who have known you for at least one year and would be willing to serve as personal references. Please include an email address for each person.



Background Reference

A background check will be performed before acceptance into this volunteer program.


Have you ever been convicted of a felony or misdemeanor?



Permission to Verify Content

I hereby authorize verification of all statements herein and release Children's Hospital and all others from liability in connection with same.