Yale New Haven Hospital

Adult Volunteer/Graduate School or College/Undergraduate

Thank you for your interest in volunteering at Yale New Haven Health System.Page Title

Before completing an application, please be sure to read the requirements on the Yale New Haven Health System volunteer website.

1. Criminal Background Check: Required for all volunteers.

2. Training Requirement: Initial Orientation, Annual Training and Assignment Specific Training provided.

3. Medical Requirements: Must be cleared by YNHHS Occupational Health Department.

4. Commitment Requirement: 3-4 hours weekly for a minimum of 60 hours.

Please complete all required fields below to establish your applicant profile and apply for a volunteer position.

Please create your user name and secure password.

Secure passwords should contain a minimum of 5 characters with at least one number, one uppercase letter and one lowercase letter.

Volunteers are responsible for the safe keeping of their passwords.

PLEASE DO NOT SHARE your password with anyone.

Please contact VolunteerServices@ynhh.org if you experience any issues completing this form. Please reach out if you do not receive an email communication within 7 days of submitting your application.

* User ID/e-mail address

* User ID/e-mail address confirm

* Password

* Password confirm

For which program are you applying? Adult (includes non-college, Graduate School, Post-Grad.) or College (undergraduate).

College Students, please choose the session you are applying for. Check all that apply.

* I am over the age of 18. I am NOT a High School Student

* First name

MI

* Last name

Preferred name

Gender

* Date of Birth

* Street Address

* City

State

* Zip/postal

* E-mail

Please enter your preferred phone number.

* Mobile Phone

Home Phone

Work Phone

Emergency Contact Information

* Name

* Relationship to you

* Mobile Phone

Home Phone

Work Phone

Education History

Highest Level of Education Completed

Are you a current student?

College/University Name

Degree Field/Area of Study

Expected Graduation Date/Graduation Date (Undergrad only)

Are you receiving credit for volunteering (i.e. college course)? Check box if yes.

Please explain:

Employment History

Employment Status

Are you eligible to work in U.S.?

Are you now or have you ever been employed at Yale New Haven Health?

Current/Most Recent Employer

Position Held

Dates (to and from)

Previous Volunteer and Community Activities

Agency/Organization

Position

Dates (to and from)

Agency/Organization

Position

Dates (to and from)

Agency/Organization

Position

Dates (to and from)

Have you ever volunteered at Yale New Haven Health System? If so, when and at which hospital?

Volunteer Interest -Tell Us About Yourself

* Briefly tell us why you are interested in volunteering at Yale New Haven Health. Also include any special skills or limitations you may have and anything else that would be helpful for us to know when placing you as a volunteer.

Interested in a Specific Assignment? Please specify.

If referred by a friend/family member/volunteer, please provide name below.

SCHEDULE: Our minimum commitment is 60 hours, typically one 3-4 hour shift per week. Please indicate your preferred availability for this commitment below. College student volunteers, we will adjust your schedule as your class schedule changes from one semester to the next.

Check all that apply.

Weekdays

Weekends

References: Two Non-Family Members

First Reference

* Name

Relationship

Organization

* E-mail

Address

Second Reference

* Name

Relationship

Organization

* E-mail

Address

* I certify the information provided on this application is complete and true. I further acknowledge falsification or omission of any significant information presented or requested on this application or during the interview process may result in rejection for a volunteer position or dismissal. I hereby authorize Yale New Haven Health to request information regarding my application for volunteer work from the references I have provided. I authorize Yale New Haven Health to take my photograph in relation to my volunteer position. For the safety of patients, their families, and hospital staff, the screening process for Yale New Haven Health volunteer applicants over age 18 includes a comprehensive background check, to be conducted with your signed authorization, following your interview in Volunteer Services.

By typing your full name here, you acknowledge you have read, understand, and agree to this statement.