JBH Volunteer Application - Youth High School
If you are in highschool, aged 15-18 years old, are able to commit to a 3-4 hour shift once a week for up to 100 hours total (approxiamately 6 months) then please fill out the
form below. Please note, that due to high volumes of applications, only those selected to continue through the process will be contacted. Applications will remain on file for 4
months, so you may be contacted at a later date.
(this will be used to send your confirmation)
Have you ever been convicted of a criminal offence which a pardon has not been granted?
Please select which area (s) you are interested in Volunteering?
Please select all the times you are available to volunteer
Morning (8am-12pm) Afternoon (12-4pm) Evening (4-8pm)
Please provide 2 References - NOT family members
If not included in list - Type School Name
Personal health information is governed by the Personal Health Information Protection Act (PHIPA) and as such, staff, physicians and volunteers are legally obligated to protect patient privacy and maintain confidentiality of all information which you may be exposed to. By selecting agree, you agree to protect patient privacy and confidentiality.
Acknowledgment of Volunteer Criteria
I am over 15 years of age.
I am aware that volunteers can request a letter verifying hours once a minimum of 100 hours of service to the hospital has been completed.
I am also aware of the need for a medical clearance to be completed after I have sucessfully completed an interview.
I agree to attend at least 80% of scheduled shifts.
I agree to wear my volunteer uniform with solid black or solid white as the approved uniform look.
Joseph Brant Hospital is committed to receiving and treating personal information in confidence.
The information in this application is collected and used by and on behalf of the organization for the purpose of evaluating the applicant's eligibility to participate in the volunteer program, for making inquiries of third parties that are necessary to evaluate the applicant's eligibility and for correspondence of record keeping necessary to manage the volunteer's relationship with the organization.
I hereby declare that all the information is true and accurate,
I authorize and consent to the organization making inquiries of third parties as are necessary to evaluate my eligibility
I acknowledge and understand that any inaccuracy or misrepresentation shall be grounds for immediate termination of the volunteer placement.
I understand that all volunteer files are kept locked and accessed by authorized personnel only.
I agree to adhere to the JBH Care Commitment of Compassion Accountability, Respect & Excellence, and will comply with the JBH Code of Conduct