Volunteer Application

To be completed by the application only. All questions must be answered or application will not be considered. Once completed, click on the submit button at the bottom of the page.

Required fields are indicated with (*)

Contact Information
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Highest level of education completed:
If student:


Program/Opportunity Preferred
Note: Please pick first and second choice below.
Refer to the Programs and Opportunities link before making your selection. Be sure that your time availability matches the schedule posted for the assignment you choose.


 Patient Hospitality ASU 
 
 
    

 


 
 
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Volunteer Availability *
Note: You may pick more than one date and time.
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
About You
All questions must be answered in order for your application to be considered.
Why do you want to volunteer at New York Hospital Queens?*
What do you hope to gain from your volunteer service?*
List and explain any other volunteer experiences you have had.*
Have you ever been convicted of a felony or misdemeanor?*
Internship/School Credit
 
If your service is related to an internship or high school community service requirement, please list the name of the coordinator, their contact information, and number of hours required.
Referral
If you were referred by someone who is affiliated with New York Hospital Queens, please list their name, title, department, and relationship to you.
Bilingual Skills
 
I understand and agree that submitting this application does not automatically register me as a New York Hospital Queens volunteer. I understand that there are other qualifications that will have to be met, including an interview, orientation, medical clearance, and a background check. By submitting this form, I attest that the information that I have provided on this application is true and accurate, and NOT provided by a third party.
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