Children's Hospital of Michigan- Volunteer Application

Personal and Contact Information

* First name

Middle Initial

* Family/Last name

* Mailing Address (Include Apt. Number)

* City

* Province

* Postal Code

Phone (Mobile)

Phone (Home)

* E-mail

* Confirm Email

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Emergency Contact

* Contact name

Relationship (Optional)

Phone (Mobile)

Phone (Home)

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Work Experience

Are you currently employed?

Please list current to previous work experience below.

Name of Organization

Position/Duties

From (MM/YY) - To (MM/YY)

1.

2.

3.

-

Volunteer Experience

Please list current to previous volunteer experience below.

Name of Organization

Position/Duties

From (MM/YY) - To (MM/YY)

1.

2.

3.

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Education

Highest Level of Education

Name of Institution (Optional)

Area(s) of Study

Availability, Schedules and Shifts

*When completing this section, please consider your other commitments and plans e.g. work, travel, school, etc..

*Shifts are approximately 3 to 4 hours

Post-secondary school students ONLY. Check all that apply.

High school students ONLY. Check all that apply.

ALL applicants- Identify your availability for the next six months.

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Which months are you available to volunteer? Check all that apply.

January

February

March

April

May

June

July

August

September

October

November

December

Is there anything else you would like to share about your availability?

Tell Us About Yourself and Your Interest in Volunteering

How did you hear about volunteering at Sunnybrook?

If Other, please specify

Why are you interested in volunteering at Sunnybrook?  Check all that apply.

* Please tell us more about why you're interested.  

Please indicate your preferred site (in order of preference)

Option 1.

Option 2.

Option 3.

Please indicate which volunteer activities interest you:

* List skills, interests, hobbies: (that may help us to determine a suitable volunteer placement):

Other

Do you have any relatives employed by Sunnybrook?

If Yes, please specify name.

If yes, in which area/department do they work?

Have you been, or are you currently employed by Sunnybrook, or affiliated with Sunnybrook in any way?

If yes, please specify role/department/site.

*Please note individuals are not permitted to have status as an employee and volunteer at Sunnybrook at the same time.

Have you ever been convicted of a criminal offense for which a Pardon has not been granted?

If yes, please explain:

References

Please ensure your reference contacts are aware that they will receive a reference form from Sunnybrook Volunteer Resources for them to complete and submit back to us.

Reference #1- Note: Family and Friends may NOT be used as a reference.

* Name

Occupation

Organization

Phone

* E-mail

How long has the reference known you?

In what capacity?  Note: Family and friends may NOT be used as a reference.

Reference #2 - Note: Family and Friends may NOT be used as a reference.

* Name

Occupation

Organization

Phone

* E-mail

How long has the reference known you?

In what capacity?  Note: Family and friends may NOT be used as a reference.

Medical Requirements for Volunteering

I understand that if I am accepted as a volunteer I will be required to complete a Medical Health Form with my physician;  this includes a 2-step Tuberculosis test and providing immunization status for Measles, Mumps, Rubella, and Varicella.

I understand that the Seasonal Flu Vaccine may be required for some areas/roles.

Terms and Conditions for Volunteering

I certify that I meet the minimum age requirement of 16 years old.

I understand that volunteers are placed according to the needs of the hospital, their interests, skills, suitability; not all applicants are accepted.

I understand that if I am accepted as a volunteer, I will be expected to demonstrate Sunnybrook's values, abide by all hosptial policies and procedures and fulfill the commitment I have made.

I understand that a Vulnerable Sector Police Check may be a requirement in order to volunteer in some areas/roles.

I understand that Sunnybrook reserves the right to dismiss a volunteer from his/her volunteer position if, in the opinion of the hospital, continuance of the volunteer could cause detriment.  

I understand that providing false or incomplete information on this application form may disqualify me from volunteering, or result in my dismissal.

I declare that the information provided on this form is true and complete to my knowledge.

* Current Date

* Current Time

Thank you again for your interest in volunteering at Sunnybrook.

Please note: you will only be contacted if you are being considered for an available role. Due to the high volume of applicants, we are unable to respond to all individual inquiries.

Click on "Save"below to submit your application.