(include city, state and zip)
|Is texting ok?|| Yes | No|
|Are you in high school or college?|| High School | College|
|Name of High School or College:|
|Current year in school:|
|Is there any type of work which your health or physical condition prohibits - or have you ever been advised by a physician to not perform certain types of work or recreation? If yes, please explain:|
|Please list number of missed days and reason for absences from school during the past two years.|
|What are your hobbies, interests and skills?|
|Why are you interested in becoming a Student Volunteer at SRHC?|
|Are there dates you will not be able to volunteer (camp, vacation, etc.)? If yes, please list.|
|In general, which days of the week and times of day (am, pm, evening) would you be available to volunteer?|
|What transportation is available to you?|
|Attendance at Student Volunteer Orientation is required.|
|I will attend the Tuesday, May 30 Orientation from 9am to Noon.
I will attend the Monday, June 5 Orientation from 1 to 4pm.
|If unable to attend either orientation, please apply another year.
|We require two character/performance references using the form found
*For complete guidelines, click here
* Bring sealed references with you to your interview