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APPLICATION
Must be over 18 years of age
New User Details
User ID
User ID (verify)
Password
Password (verify)
Where are you applying to?
Baptist Medical Center Downtown
Wolfson Children's Hospital
Highest need
Title
Dr.
Father
Hon.
Miss
Mr.
Mrs.
Ms.
Sister
*
First name
*
Last name
Middle name
Preferred first name spelling for ID badge:
*
Birthdate:
Spouse Name
Present Address
Street Address
Apartment number
*
City
State
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DE
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MS
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PA
PE
PR
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VA
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VT
WA
WI
WV
WY
YT
*
Zip/postal
Home Telephone
Work Telephone:
*
E-mail
Cell phone (optional)
What is your current occupation?
If you are a student, please list your field(s) of study:
Employment and/or Student History
Experience #1:
Years:
Experience #2:
Years:
Experience #3:
Years:
REFERENCES:
Include first and last name, complete address, zip code, telephone and e-mail of three references you have known more than one year. Non-relatives only and provide at least one work reference. To avoid a delay in processing your application, please provide complete information including zip codes and email.
*
Reference #1: Name
*
Street Address
*
City
*
State
*
Zip/postal
*
Phone
*
E-mail
Preferred method
Phone call
*
Reference #2: Name
*
Street Address
*
City
*
State
*
Zip/postal
*
Phone
*
E-mail
Preferred method
E-mail
Letter (printed)
*
Reference #3: Name
*
Street Address
*
City
*
State
*
Zip/postal
*
Phone
*
E-mail
Preferred method
E-mail
Letter (printed)
What is your current availability?
Sunday
8am-Noon
Noon-4pm
4pm-8pm
Monday
8am-Noon
Noon-4pm
4pm-8pm
Tuesday
8am-Noon
Noon-4pm
4pm-8pm
Wednesday
8am-Noon
Noon-4pm
4pm-8pm
Thursday
8am-Noon
Noon-4pm
4pm-8pm
Friday
8am-Noon
Noon-4pm
4pm-8pm
Saturday
8am-Noon
Noon-4pm
4pm-8pm
How did you learn about us?
Reason for volunteering
Previous volunteer experience(s) & location(s)
Please list your special interests, skills and/or hobbies
Administration/Office
Advertising
Art
Artist
Audio/Visual
Baking
Bookkeeping
Calligraphy
Child Care
Child Life
Clerical
Clown
Computer - Data entry
Computer - IT general
Construction - Carpentry
Construction - Electrical
Construction - General
Construction - Painting
Construction - Plumbing
Crafts
Custodial
Event Planning
Food Services - Delivery
Food Services - Preparation
French Language
Fundraising
Gardening
Grant Writing
Graphic Design
Language/Translator
Law Enforcement
Legal
Library
Magic
Marketing/Communications
Medical - Doctor/Physician
Medical - First Aid
Medical - General
Medical - Nursing
Music
Musician
None Listed
nursing
Patient Interaction
Pet Therapy
Photography
Physical Therapy
Planning
Political/Government
Public Relations
Public Speaking
Puppets
Reading
Sales/Cashier
Scrapbooking
Secretarial
Sewing
Soccer
Spanish Language
Speech Pathology
Sports
Sports - Coaching
Sports - Official
Teaching
Transportation - Driver (bus/van)
Transportation - Driver (car)
Transportation - Emergency
Transportation - Moving
Transportation - Parking
Video Production
Vocal
writing
Writing/Reporting
What was your primary language?
Afrikaans
Akan
Aklanon
Albanian
Algerian
Amharic
Arabic
Arawakan
Armenian
ASL
Avestan
Ayapathu
Aymara
Azeri
Bamwe
Bantu
Basa
Basque
Belarusan
Bemba
Bengali
Berber
Bicol
Bisaya
Bobangi
Bosnian
Brahui
Breton
Bukusu
Bulgarian
Burmese
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Byelorussian
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Ch'ol
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Chinese
Chinook
Chorti
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Creole
Croatian
Czech
Danish
Dari
Demonh'ka
Dothraki
Dutch
Ebu
Eggon
Egyptian
Emakua
English
Eskimo
Estonian
Etruscan
Fang
Faroese
Farsi
Filipino
Finnish
Flemish
Frankish
French
Fujanese
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Gaelic (Irish)
Gaelic (Scottish)
Gaelic (Welsh)
Galician
Gamilaraay
Ganda
Gaulish
Gbari
Georgian
German
Gevove
Gilbertese
Gothic
Greek
Guarani
Gujarati
Guyanese Creole patois
Haida
Haitian
Hakka
Halaka
Hausa
Hawaiian
Hebrew
Hiligaynon
Hindi
Hmong
Hungarian
Icelandic
Igbo
Ilocano
Ilonggo
Indonesian
Ingush
Inupiat
Italian
Japanese
Jita
Kachi
Kakwa
Kalanga
Kannada
Kapampangan
Karelian
Kashmiri
Katcha
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Kerewe
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Khowar
Kiga
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Klingon
Kongo
Konkani
Korean
Koyo
Kurdish
Lakhota
Latin
Latvian
Lebanese
Lingala
Lithuanian
Lozi
Luganda
Luwian
Lycian
Lydian
Mabwe
Macedonian
Malay
Malayalam
Maliseet
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Mandinka
Manx
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Nauruan
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Papiamento
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Zulu
Emergency Contacts
Emergency Contact name
Relationship name
Phone (Home)
Phone (Mobile)
Phone (Business)
Emergency Contact #2 name
Relationship name
Phone (Home)
Phone (Mobile)
Phone (Business)
Application date
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Applicant's Signature
