College and Graduate Volunteer Application

Program Information: This program is designed for college, graduate, medical or any other students ages 18 and up who are following a semester schedule. It runs from September 6th through December 2nd for the Fall Term. Winter break is from December 3rd through January 17th. The Spring Term is from January 18th through April 14th. The goal for completion of this program is 100 hours of service.

* First name

* Last name

* Home Address:

Apt. or Ste. #

* City

State

* Zip/postal

* Primary Phone Number

Phone (Mobile): By providing my mobile number, I agree to receive recurring text messages from CHOP and its affiliates/partners via automated means to my mobile number for any reason related to the CHOP Volunteer Program. I understand that my consent to receive text messages is not required to participate in the CHOP Volunteer Program or purchase any goods or services from CHOP (e.g., CHOP healthcare services).  I understand that message and data rates may apply, and I may request to opt out of text messaging at any time by texting 'stop' in reply to any CHOP text sent to me. 

Have you volunteered at CHOP in the past?

What was the last year you volunteered?

I am currently an undergraduate college or university student or a graduate or medical school student.

* College or University Name

College Major or Course of Study:

Graduation Date

I attest that I am 18 years or older and that I will commit to the same four-hour volunteer shift for the Fall and Spring semester.

I understand I will need to comply with a background check, including but not limited to FBI fingerprinting.

I will provide evidence of immunity, vaccine and/or blood test results for the following:TBMMR (Chicken Pox)TdapFlu (seasonal)COVIDI further understand that CHOP makes no exemptions for the aforementioned requirements. CHOP will provide instructions and cover approved costs for background checks and medical screenings.

How did you hear about the Volunteer Program at CHOP?

Please share any previous volunteer experience.

A Note about Volunteer Placement: CHOP assigns volunteer positions based on the current needs of the hospital along with the volunteer's availability, interests and skill sets.

Volunteer Interest Area(s)

* As a volunteer, how do you see yourself helping to improve the CHOP experience for patients and families? Briefly explain below.

Significant Life Change: Have you had a significant life change including but not limited to an experience or personal loss within the last 12 months that would impact your ability to serve in certain areas of the hospital or keep your commitment?

If you have had a significant life change including but not limited to the loss a loved one within the past 12 months please consider sharing. We have found volunteering can be difficult after a recent loss and/or some significant life changes and want each volunteer to have a successful experience.

* Connection to Children's Hospital of Philadelphia: Please tell us about any personal connections you have with Children's Hospital of Philadelphia or its employees. If you have family members or friends who are employees or volunteers, please list their name(s) and department of service. If you have none, please type 'none' as your answer.

All of our volunteer opportunities will require some walking, standing, bending and light lifting for 4-hour shifts. Will you be able to perform these tasks?

This role requires that volunteers work independently. Is this something that you feel comfortable doing?

Do you have any specific challenges or limitations that you wish to disclose? If so, please share below.

Volunteers are expected to wear a CHOP Wawa Volunteer Services t-shirt during all shifts. The shirt comes in unisex sizes XS-XXXL. What size shirt would you like?

Application Agreement: I understand and agree that submitting this application form does not automatically qualify me to be a Children's Hospital of Philadelphia (CHOP) volunteer, and that there may be certain qualifications I must meet, including the established volunteer policies and procedures, before I may begin volunteering. I affirm that the information provided in this application is true and complete. Falsification of any information can result in immediate dismissal from the CHOP Volunteer Services Department. I hereby give my permission and authorize representatives of Children's Hospital of Philadelphia to investigate any or all statements I have made in this application. I understand that as volunteer, I may not accept payment, benefits or compensation for my service. I understand that the Wawa Volunteer Service Department will not write letters of recommendation, however it will confirm my volunteer start and end date with total hours upon request. I understand that my volunteer service does not guarantee or secure employment with CHOP and that my volunteer service does not give me any advantage over other applicants for open positions with CHOP. I understand that CHOP will do its best to take into account my preference when assigning volunteer duites and roles; however, I understand CHOP reserves the right to place volunteers in different assignments based on need and other factors, and may change the duties assigned to a volunteer at any time. As a volunteer, I understand that I am not an employee of CHOP and my volunteer position is not a promise or a guarantee of any future employment with CHOP. I will make reasonable efforts to complete at least 50 hours of volunteer service over a six-month period of time. These hours are generally served in one regular shift of three to four hours each each week not exceeding 12 hours any week. Any exceptions must be agreed upon in advance during your interview or placement appointment.

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