SKY LAKES MEDICAL CENTER JUNIORVOLUNTEER PROGRAM
WHO CAN JOIN?
Teenagers who are 14 years old and have completed the eighth grade may apply for the program.
SkyLakesMedicalCenter Junior Volunteers may volunteer until graduation from high school.
HOW TO JOIN?
- Fill out the application and return it to Volunteer Services.
- Give each person you ask for a reference, a reference form with a self-addressed stamped envelope:
Volunteer Services
SkyLakesMedicalCenter
2865 Daggett Av
Klamath Falls, OR 97601-1180
OR the References may be submitted electronically by e-mail to:
HOW DO I KNOW IF I'M ACCEPTED INTO THE JUNIOR VOLUNTEER PROGRAM?
Applications may be submitted at any time. Volunteer orientations are scheduled approximately quarterly throughout the year. Applicants will be notified of the orientation date. YOU ANDONE PARENT ARE REQUIRED TO ATTEND ORIENTATION BEFORE YOU BEGIN YOUR VOLUNTEER TRAINING.
If you cannot attend the orientation date you are notified of, you must wait until the next orientation.
Prior to each Orientation, we will notify applicants of the Orientation date, time and location.
To verify the status of your application, you may contact Volunteer Services, at 541-274-2038.
TB TESTS AND PHOTO IDENTIFICATION REQUIREMENTS
TB Testing is required before training begins and will be provided by SkyLakesMedicalCenter.
A Photo Identification badge will be provided by SkyLakesMedicalCenter, to be worn while on duty.
SERVICE AREA OPPORTUNITIES
Junior Volunteers assist at the main lobby Information Desk.
Junior Volunteers assist staff in other assignments following the completion of special training.
HOW OFTEN DO I VOLUNTEER? WHAT DO JUNIOR GUILD VOLUNTEERS DO?
You volunteer at least twice a month; to maintain your level of knowledge.
A minimum of four (4) volunteer hours per month or forty-eight (48) volunteer hours per year.
Junior Volunteers greet and escort patients and visitors, do wheelchair transports, deliver flowers, answer telephones, give out patient room numbers, deliver paperwork to departments and other duties as assigned.
HOW MUCH WILL IT COST?
A One-Time joining fee of $5.00 and payable at the Orientation.
The girls popover top and boys scrub top are $15.00, these must be purchased before training begins.
SKY LAKES MEDICAL CENTER JUNIORVOLUNTEER APPLICATION
PLEASE PRINT CLEARLY
NAME AGEBIRTHDATE
Last namefirst namemiddle initial
Home PHONECell PHONEEmail
ADDRESSCITYSTATEZIP
CURRENTGRADUATION
SCHOOLGRADE______YEAR
REFERENCES: You MUST ask for a written reference from three adults, NOT RELATIVES, who know you well. One reference must be from a teacher who has had you in class during the past year. Please list the names and relationships of those you have asked to complete a reference form, reference forms are included with this application.
NameRelationship
1.
2.
3.
IN CASE OF ILLNESS WHILE ON DUTY, THE PERSON WE SHOULD CONTACT?
name relationship
address
home phone cell phonework phone
ACTIVITIES you are involved in
WHY DO YOU WANT TO BE A JUNIOR VOLUNTEER?
If I am accepted into the Sky Lakes Medical Center Junior Volunteer Program I will be dependable, responsible, confidential, neat and clean, punctual and courteous while in the Junior Volunteer Program. I understand I will be required to have a TB Test that will be provided by The Medical Center.
I declare that all the foregoing statements are true and correct to the best of my knowledge. I also authorized The Medical Center to conduct a background check and to contact my references to make inquiries to determine my suitability for service and training. I hereby release them and The Medical Center from all liability for issuing or receiving same. All facts stated in the application are open to investigation and if anything contained herein is found to be false and misleading, I understand that I will be subject to dismissal at any time without notice. I agree that if accepted into the Junior Volunteer Program, I will abide by all policies and procedures established by The Medical Center.
Signature of Junior Volunteer Applicantdate signed
FOR PARENT or GUARDIAN:has my permission to participate in the Junior Volunteer Program at Sky Lakes Medical Center. I understand that he/she will be required to have a TB Test that will be provided by SkyLakesMedicalCenter. I understand a parent or guardian MUST attend the Volunteer Orientation with my teenager.
printed name of parent or guardian
signature of parent or guardian date signed
Rev 11/24/17
SKY LAKES MEDICAL CENTER JUNIOR VOLUNTEERS
REFERENCE SHEET
please print
APPLICANT'S NAME
APPLICANT'S ADDRESS
CITYSTATE ZIP
APPLICANT'S SCHOOL
Before accepting a teenager into the Sky Lakes Medical Center Junior Volunteer Program, we need to know something about the applicant. Please give your opinion on the applicant's character based upon dependability, punctuality, maturity, and attitude toward other people. Please include how long you have known the applicant and in what capacity you know the applicant, i.e., neighbor, teacher, friend, and church or club member.
Also any other information you think would be helpful. Thank you!
Please use the other side of the page if you need more space.
your signature date
please print your name here
address
citystatezip
PLEASE RETURN TO:Director of Volunteer Services ORReferences may be
Sky Lakes Medical Centersubmitted electronically by
2865 Daggett Avenuee-mail to:
Klamath Falls, OR 97601-1180 or fax 541.274.2037
SKY LAKES MEDICAL CENTER JUNIOR VOLUNTEERS
REFERENCE SHEET
please print
APPLICANT'S NAME
APPLICANT'S ADDRESS
CITYSTATE ZIP
APPLICANT'S SCHOOL
Before accepting a teenager into the Sky Lakes Medical Center Junior Volunteer Program, we need to know something about the applicant. Please give your opinion on the applicant's character based upon dependability, punctuality, maturity, and attitude toward other people. Please include how long you have known the applicant and in what capacity you know the applicant, i.e., neighbor, teacher, friend, and church or club member.
Also any other information you think would be helpful. Thank you!
Please use the other side of the page if you need more space.
your signature date
please print your name here
address
citystatezip
PLEASE RETURN TO:Director of Volunteer Services ORReferences may be
Sky Lakes Medical Centersubmitted electronically by
2865 Daggett Avenuee-mail to:
Klamath Falls, OR 97601-1180 or fax 541.274.2037
SKY LAKES MEDICAL CENTER JUNIOR VOLUNTEERS
REFERENCE SHEET
please print
APPLICANT'S NAME
APPLICANT'S ADDRESS
CITYSTATE ZIP
APPLICANT'S SCHOOL
Before accepting a teenager into the Sky Lakes Medical Center Junior Volunteer Program, we need to know something about the applicant. Please give your opinion on the applicant's character based upon dependability, punctuality, maturity, and attitude toward other people. Please include how long you have known the applicant and in what capacity you know the applicant, i.e., neighbor, teacher, friend, and church or club member.
Also any other information you think would be helpful. Thank you!
Please use the other side of the page if you need more space.
your signature date
please print your name here
address
citystatezip
PLEASE RETURN TO:Director of Volunteer Services ORReferences may be
Sky Lakes Medical Centersubmitted electronically by
2865 Daggett Avenuee-mail to:
Klamath Falls, OR 97601-1180 or fax 541.274.2037