Welcome to The Hospital of Central Connecticut Volunteer Application Page
Teen Volunteer Application
I am applying for the Summer 2020 Teen Program
I am 15 years or older
Town of School
Previous Volunteer Experience
Name of individual NOT related to you who will fill out reference form (Teacher, guidance councilor, etc.)
Do either of your parents work at Hartford Healthcare?
How did you hear about our program?
Please list any special skills or talents that you may have (languages spoken, musical instrument played, singing etc.)
What do you want to get out of your time as a volunteer?
Check here if you are required to do community service
If yes, how many hours do you need to complete?
I agree to abide by the policies and regulations of Hartford Healthcare and the Volunteer Services Department and to participate in orientation and training required by the hospital.
I will hold as absolutely confidential all information that I may obtain directly or indirectly concerning patients or personnel and not seek to obtain confidential information from a patient.
I understand that I may be dismissed from my duties if I fail to comply with hospital policies and procedures, willful wrongdoing or negligence and/or performing duties outside of my service guidelines, inappropriate behavior or any other circumstances deemed contrary to the best interests of the hospital by the Manager of Volunteer Services.
I certify that the facts set forth in this application are true and complete to the best of my knowledge.
I understand that if I am accepted into the Volunteer Services program, false statements may result in my dismissal.
I understand that I am expected to inform the Department of Volunteer Services of any significant change in my health status that would negatively impact my ability to perform the tasks to which I am assigned.
I understand that when the flu season begins, the influenza vaccination (flu shot) will be required.
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