Fillable WFBH Wilkes Summer VolunTeen Program Applicant (Wake Forest Baptist Health)

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WFBH Wilkes Summer VolunTeen Program Applicant (Wake Forest Baptist Health)

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WFBH Wilkes Summer VolunTeen Program Applicant
Thank you for your interest in our 2020 WFBH Wilkes Medical Center Summer VolunTeen Program! The
Summer VolunTeen Program is designated for students ages 14-18 (applicant must be 14 years old by June 1,
2020 and not graduating this school year). It is essential that you pay close attention to the
information provided to you and that you are aware of the 5pm, Friday, March 6, 2020 deadline
by which ALL of the application packet information must be submitted to Wilkes Patient & Family
Relations. In order to ensure the quality of the Program, there are limited spaces available. Late or
incomplete packets will not be considered.
Attendance to the VolunTeen Orientation is mandatory. The Orientation will be held on
Wednesday, June 17
th
from 5:30pm – 7:30pm. There will not be a makeup session.
The 6-week Summer VolunTeen Program will run from Monday, June 29
th
- Friday, August 7
th
. Each
VolunTeen will be required to volunteer 2 assigned afternoons each week. The assigned Monday –
Thursday volunteer days will remain the same each week from 12:30pm – 5:30pm. Each VolunTeen must
dedicate 60 volunteer hours in order to complete the requirements for the Program and participate in the
Program the following summer (if applicable). Sub days will be available with prior approval from the
VolunTeen Coordinator. Volunteering more than the required 60 hours will not be allowed due to scheduling
and staff constraints.
The Summer VolunTeen Program’s primary goal is to teach the Medical Center’s core values and provide
experiences that foster inner growth, maturity and strengthen a service-oriented mind. VolunTeens are not
allowed to administer any type of clinical care. The VolunTeen duties will help to enhance the patient and
family centered care provided each day. VolunTeen duties are customer service driven and will
involve various departmental tasks as well as performing administrative duties. Each task is
performed in the Medical Center setting, providing a wonderful opportunity for students to learn and explore
healthcare careers while helping our patients and guests have a positive experience during their visit. While
educational opportunities will be provided, this Program is not a shadowing/observation experience.
A complete application packet contains: An online Application submitted by the deadline and a
complete Application Packet that must be mailed to or dropped off in Wilkes Patient & Family
Relations no later than 5pm on March 6, 2020. All documents in the application packet must be
submitted together and filled out completely/correctly for further consideration for the Program. If an
incomplete packet is received, it will not be considered eligible for review.
The completed application packets will be reviewed by the Selection Committee to determine which students
will be invited to participate in the Program. All applicants will be informed of their status by May 1, 2020.
The selected participants will be required to attend a group Information Session with a parent/guardian in
May to learn more about the Program and to ensure that each student/parent/guardian knows the
expectations of the Program. After the Information Session, the participants will be required to take
a copy of their immunization record to Wilkes Medical Center to receive a free Tuberculosis (TB)
blood test before the designated deadline. A free criminal background check will be performed
also. There will be no exceptions to the application deadline and the Program requirements.
Sincerely,
Kayla M. Absher
Patient & Family Relations Manager/VolunTeen Coordinator
kaabsher@wakehealth.edu
(336) 651-8198
WFBH Wilkes Summer VolunTeen Program Registration Checklist
Due Date: No later than 5pm on Friday, March 6, 2020
Following instructions closely is an important step to becoming a Summer VolunTeen and will show Volunteer
Services that you are very responsible. This list is to ensure there is no confusion about what you need to do
to become a Summer VolunTeen and to make certain that all forms are completed and submitted on time.
(Do Not submit this Checklist with your application packet.)
Check each of the following off as you complete it. Do NOT wait until the last minute to complete
these forms. Deadline extensions will not be available.
Locate and complete the application posted on the Volunteer Services website
www.wakehealth.edu/volunteer and read through the additional forms with a parent/guardian.
Discuss summer plans and whether you will be able to attend the Orientation on Wednesday,
June 17
th
AND if you can commit to volunteering 2 days per week from June 29 - August 7.
We stress this to you because if there are unavoidable conflicts with these dates, our policy will
not permit you to participate this year. Make sure to provide current and accurate contact
information including telephone numbers, email and mailing address. You MUST submit a
“Summer VolunTeen – Wilkes” application through the Volunteer Services website.
Ask two of your
current
core curriculum teachers to fill out a recommendation form for you. Be
sure to give each teacher adequate time to complete the form. Recommenders should put
the form in a sealed and signed envelope. Unsealed & unsigned envelopes will not be
accepted resulting in incompletion of materials.
Note: Please have teachers return forms
directly to YOU-do not depend on them to mail them to us-they need to be returned
with all of your forms!
Complete packets must contain the following forms:
Typed Essay (NOT handwritten)
Signed Agreement and Parental Consent
2 Teacher Recommendation Forms
Mail or drop off:
Kayla Absher, VolunTeen Coordinator
WFBH Wilkes Medical Center
Patient & Family Relations
1370 West D Street
North Wilkesboro, NC 28635
WFBH Wilkes Summer VolunTeen Program Essay
Applicant’s Name:
Please TYPE (DO NOT write) your answers to the following questions below.
What does volunteerism mean to you?
Why do you want to volunteer 60 hours at Wake Forest Baptist during your summer break?
What other volunteer opportunities (past and present) have you been/(are) a part of?
What qualities do you have to make you a great fit for the VolunTeen Program?
What are your thoughts about the Summer VolunTeen Program’s No Tolerance Mobile Phone
Policy?
How would you handle a difficult/negative situation with a patient or guest?
WFBH Wilkes Summer VolunTeen Program
Agreement and Parental Consent
Please TYPE (DO NOT write) the information below except signatures
By submitting this application, I affirm that the facts set forth in it are true and complete. I understand
that if I am accepted as a VolunTeen, any false statements, omissions, or other misrepresentations
made by me on this application may result in my immediate dismissal. If I am accepted into this
Program, I agree to follow all policies and procedures of the Summer VolunTeen Program including
the VolunTeen Code of Conduct Policy and understand if I am unable to do so, I may be dismissed
from the Program.
Applicant’s Name:
Applicant’s Signature:
Date:
Email Address:
Telephone Number:
I, ____________________________ , have read all of the registration information and consent to
(Type Parent/Guardian’s Name)
allow my child, ________________________________, to apply and be considered for the 2020
(Type Applicant’s Name)
Summer VolunTeen Program.
Signature: Date: ____________________
Parent/Guardian’s Contact Information:
Mobile #: _____________________________________
Home #: ______________________________________
Work #: ______________________________________
Email: ________________________________________
WFBH Wilkes Summer VolunTeen Program
Teacher Recommendation Form
Applicant Information
Name
Current Grade Level
School
Teacher Information
Name
Subject
Phone Number
E-Mail Address
TO THE APPLICANT:
Fill out the Applicant Information section above and take it to a current core curriculum teacher
whom you have asked to recommend you for our Program. Please allow your teacher a few days to complete the
recommendation form. Forms must be submitted to Volunteer Services in a signed and sealed envelope along with the
rest of your application by 5pm, March 6, 2020.
TO THE RECOMMENDER:
Please answer the following questions about the student named above. This student is
applying to the Summer VolunTeen Program at Wake Forest Baptist Health. The Medical Center is a very sensitive
environment that requires a great deal of maturity but also the ability to adapt to new situations. We would appreciate
your insight about the student’s responsibility and dependability as well as his/her maturity. In addition, any comments
that would help us to learn more about this student are welcome.
Please make sure to place this form in a sealed envelope and place your signature across the seal. Please
make sure to return this form to the applicant in time for it to be submitted to us by 5pm, March 6, 2020.
On a scale from 1 to 5, rate the applicant on the following items.
1 = Strongly Disagree 2 = Disagree 3 = Unknown 4 = Agree 5 = Strongly Agree
I know the applicant very well. 1 2 3 4 5
I can depend on the applicant to complete assigned tasks without
prompting and on time.
1 2 3 4 5
The applicant acts maturely around both his/her peers and adults. 1 2 3 4 5
The applicant enjoys helping others. 1 2 3 4 5
The applicant will have no issues adhering to all policies & procedures,
including the restriction of mobile phone usage and Code of Conduct.
1 2 3 4 5
There are no classroom behavioral issues with the applicant. 1 2 3 4 5
The applicant adapts well to new or difficult situations. 1 2 3 4 5
The applicant is a very responsible team player with a positive attitude. 1 2 3 4 5
______________________________________________________________________
Teacher’sSignatureDate
WFBH Wilkes Summer VolunTeen Program
Teacher Recommendation Form
Applicant Information
Name
Current Grade Level
School
Teacher Information
Name
Subject
Phone Number
E-Mail Address
TO THE APPLICANT:
Fill out the Applicant Information section above and take it to a current core curriculum teacher
whom you have asked to recommend you for our Program. Please allow your teacher a few days to complete the
recommendation form. Forms must be returned to Volunteer Services in a signed and sealed envelope along with the
rest of your application by 5pm, March 6, 2020.
TO THE RECOMMENDER:
Please answer the following questions about the student named above. This student is
applying to the Summer VolunTeen Program at Wake Forest Baptist Health. The Medical Center is a very sensitive
environment that requires a great deal of maturity but also the ability to adapt to new situations. We would appreciate
your insight about the student’s responsibility and dependability as well as his/her maturity. In addition, any comments
that would help us to learn more about this student are welcome.
Please make sure to place this form in a sealed envelope and place your signature across the seal. Please
make sure to return this form to the applicant in time for it to be returned to us by 5pm, March 6, 2020.
On a scale from 1 to 5, rate the applicant on the following items.
1 = Strongly Disagree 2 = Disagree 3 = Unknown 4 = Agree 5 = Strongly Agree
I know the applicant very well. 1 2 3 4 5
I can depend on the applicant to complete assigned tasks without
prompting and on time.
1 2 3 4 5
The applicant acts maturely around both his/her peers and adults. 1 2 3 4 5
The applicant enjoys helping others. 1 2 3 4 5
The applicant will have no issues adhering to all policies & procedures,
including the restriction of mobile phone usage and Code of Conduct.
1 2 3 4 5
There are no classroom behavioral issues with the applicant. 1 2 3 4 5
The applicant adapts well to new or difficult situations. 1 2 3 4 5
The applicant is a very responsible team player with a positive attitude. 1 2 3 4 5
______________________________________________________________________
Teacher’sSignatureDate
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WFBH Wilkes Summer VolunTeen Program Applicant (Wake Forest Baptist Health)

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Completed 15 August 2020

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