Beth Israel Deaconess-Plymouth

Junior Volunteer Application

Beth Israel Deaconess Hospital Plymouth offers a junior volunteer program to those aged 16 to 18 years old. Participants must commit to one 4-hour shift per week for al least one high school season: Fall, Winter or Spring. Junior volunteers typically volunteer after school or on the weekend. Volunteer positions range from Floor Volunteer Helper, Escorting, Lending Library Liaison, Surgical Services Liaison, Endoscopy Liaison, etc. Positions dependent on time of year for student. A variety of opportunities await you when you walk through the doors of Beth Israel Deaconess Hospital Plymouth. Your experiences can be the key to a new and exciting future.

Personal Information

* First name

Middle name

* Last name

* Street Address:

Mailing Address if Different than Street Address:

* City

State

* Zip

* Phone

* E-mail

* Date of Birth

School and Current Grade

Shirt size for Uniform

Brief paragraph describing yourself, why you would like to be accepted into the Volunteer Program and a summary of your skills/Achievements/ hobbies/ interests

Volunteer Questionnaire

Are you prepared to commit to one 4-hour shift/week for at least one High School season: Fall, Winter or Spring?

Please tell us why you would like to volunteer at Beth Israel Deaconess Hospital Plymouth.

Please describe for us a time when you have interacted with someone who was ill or recovering from a physical or mental illness. What were your challenges and successes?

Please list and describe any volunteer positions you have previously held.

Please tell us about any work or life experiences that you think has prepared you to succeed as a hospital volunteer.

Do you have any special skills, talents or interests that you would be willing to share with us?

TO BE COMPLETED BY PARENT OR GUARDIAN

Parent or Guardian

* Parent/Guardian's name

* Phone

Emergency Contact

* Emergency contact's name

* Relationship

* Phone

Physician

* Physician's name

* Phone

Is he/she currently take any medications:

If yes, please give name(s) of medication and dosage:

I give my full consent to have my child volunteer at Beth Israel Deaconess-Plymouth.

Signature of Parent/Guardian: (Typed name accepted as Electronic Signature)

References

Three letters of recommendation are required. The references must be adults (over age 22) and may NOT be a family member. One should be a teacher or guidance counselor. Send all references via e-mail to volunteerservices@bidplymouth.org with your name in the subject line.

Expectation and Commitment

Be at least 16 and no more than 18 years old.
Be able to commit to one 4-hour shift per week for at least on high school season: Fall, Winter or Spring.
Be on time, reliable and consistent.
Have transportation to and from the hospital.
Be available to attend the mandatory orientation program in June or July. Orientation is held every other Monday from 8:15am to 12:30pm. An absence note will be provided upon request.

A Junior volunteer, not a parent or guardian, is expected to take responsibility for any necessary communication with the Volunteer Office.

All volunteers should notify the Volunteer Office as soon as possible if time off is needed for vacations, camps, retreats, etc., so we can schedule appropriately. The absence policy can be found in the Volunteer Handbook.

Excessive, unplanned absences, improper dress or manner or any disregard for hospital or departmental policies and procedures will be grounds for immediate termination of volunteer assignment.

A $20 application fee paid by check must be brought to the orientation. This fee covers the background check and polo shirt. The check should be made payable to Volunteer Services. NO CASH will be accepted.

PLEASE NOTE ALL VOLUNTEERS ARE REQUIRED TO HAVE THEIR MMR, TB, VARICELLA, FLU IN SEASON, THE ORIGINAL COVID SERIES PLUS ONE BOOSTER OR THE COVID BIVALENT VACCINE. This is provided by our Occupational Health department at no cost to you. You will be directed to Occ. Health after the interview process.

Commitment Agreement

As an applicant and parent/guardian of an applicant to the Volunteer Program, we understand the outlined expectations and agree to adhere to them. As the student I understand I am making a formal commitment of at least one 4-hour shift/week during the Fall, Winter or Spring season of High School to Beth Israel Deaconess-Plymouth and fully intend to fulfill this commitment. I also understand that Volunteer Services will not sign-off on any community service forms until the entire commitment has been met. Please sign the commitment agreement below.

As the volunteer I agree to the above statement.

As the parent/guardian I agree to the above statement.

* Signature: (Typed name accepted as Electronic Signature)

* Date: