High School Volunteer Application

Please allow yourself approximately 15 minutes to accurately and thoroughly complete this volunteer application.
High school students need to be 16 or older and possess a 3.0 grade point average or higher to be eligible for volunteering at Covenant HealthCare.
Once a student is accepted into our program, a two-step TB test and mandatory orientation need to be completed prior to student volunteering at Covenant HealthCare.
Student needs to be able to commit to 40 hours of volunteer service through the high school volunteer program.
If you have trouble or need assistance, please contact Volunteer Services at 989.583.6040.
Thank you for your interest in volunteering at Covenant HealthCare!

New User Details

User ID

User ID (verify)

Password

Password (verify)

Applicant Information

* First name

* Family/last name

Preferred First Name

* Date of Birth

* Home address

* City

* State

* Zip Code

* Primary phone

Mobile phone

* E-mail address

Gender

Race/Ethnicity (Optional)

Emergency Contact Information

* Contact name

* Primary phone

E-mail address

* Relationship

References

Please provide name and phone number for two references. Do not list relatives.

* Name

* E-mail

Phone

Relationship

* Name

* E-mail

Phone

Relationship

Volunteer Experience

Other volunteer services you have participated in. Please include type of duties performed.

Education

Last Completed Grade

* High School

* City/State

* Grade Point Average (Taken from last report card) - will be verified by the school

Skills and Scheduling

* Please share with us why you would like to volunteer at Covenant HealthCare and what skills you would bring to our organization.

Select the days you are available to volunteer

Select the time of day you would like to volunteer

What amount of time are you prepared to share with us?

If other commitments than above, please specify

Additional Information

Additional information or comments you would like to share with us prior to submitting your application?

Authorization and Signature

* I understand that 40 hours of volunteer service need to be completed prior to a letter of recommendation written or a release of hours provided to the school.

I certify that the responses on this application are true to the best of my knowledge. I agree that this information may be verified and my references may be contacted by Covenant HealthCare Volunteer Services. I authorize Covenant HealthCare to perform all necessary background checks and understand my date of birth is necessary for these checks. If accepted for volunteer placement, I will comply with the values, policies and procedures of Covenant HealthCare in effect or revisions which may be issued in the future. Misrepresentation of facts constitutes cause for separation from volunteer placement. I understand that the position that I am applying for is an unpaid volunteer position.

* I agree

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E-Signature