AUXILIARY TEEN VOLUNTEER APPLICATION

First Name*

Last Name*

Teen Email*

Street Address*

City*

Zip Code*

Teen Phone*

Phone

Birth Date*

Age*

Parent/Guardian 1*

Parent/Guardian Occupation*

Parent/Guardian 1 Phone Number*

Phone

Parent/Guardian 1 email*

Parent/Guardian 2

Parent/Guardian 2 Occupation

Parent/Guardian 2 Phone number

Phone

Parent/Guardian 2 Email

School*

GPA*

Grade Next August*

Year Graduate High School*

Organizations currently involved in*

Hobbies*

Special Talents/Languages*

Physical Limitations*

Off Time*

Because of the importance of Teen Volunteer assignments during the summer, please limit times you will have to be off. Please list all planned vacations, camps, etc. here. Keep in mind you must be available to volunteer 7 of the 10 weeks.

Shirt Order*

Adult Sizing

Select

My parent/Guardian understands that I am applying to participate in the Teen Hero Volunteer activities at Norman Regional Health System.

Parent/Guardian Check box*

By checking this box I promise to abide by the rules and regulations of the Teen Volunteer Program as set forth by the Department of Volunteer Services.

Teen Check box*

100- Word Essay and Letter of reference*

In addition to the application above please submit 1) a 100-word essay detailing why you would like to be a teen volunteer at NRHS, and 2) a letter of reference.

The letter of reference must be submitted on official letter head and it must describe how the person is associated with the applicant, how long they have known the applicant, and detail key characteristic of the applicant including leadership skills, working with others, communications skills, etc.

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