Johns Hopkins All Children's Hospital Volunteer Access Page

Adults interested in volunteering must be at least 18 years old and completed high school. Teen volunteers must be at least 14 years of age and have completed the ninth grade.

Cookies & Converstaion Volunteer

Cookies & Conversation Volunteer Application

* Indicates Required Fields to Submit Application
Your Information
First Name*
MI
Last Name*
Home Address Line 1*
Home Address Line 2
City*
State
Zip Code*
Home Phone
Cell Phone
E-mail Address*
DOB
Gender
Volunteer Type*
Teen - Must have completed the ninth grade.
Adult - 18+ year of age and completed highschool
Emergency Contact Information
Contact Full Name
Relationship (e.g. husband, wife, father, mother)
Home Phone
Cell Phone
E-mail
Work Information
Company Name
Work phone
Years Employed:
School Information
I am currently a student
Expected Graduation
High Schools
Colleges
If your school is not listed, please do so here:
Community Involvement
Do you belong to any community or civic organizations?
If YES, please specify:
Are you currently a volunteer, or have done volunteer work in the past?
If YES, please specify:
Volunteering
Why would you like to volunteer?*
Please explain your desire for volunteering futher*:
Disclose any physical limitations which may require accommodations to volunteer

Statement of Understanding And Agreement

Johns Hopkins All Children's Hospital (JHACH) is a drug free campus. I understand that by applying for a volunteer position, if accepted, I may be subject to a drug screening.

JHACH requires volunteers to commit to volunteering a minimum of 60 hours over a six month period (generally one day a week for two to four hours). This requirement must be fulfilled in order to receive any correspondence (i.e. Hours, Letters of recommendation, etc...) from the Volunteer Resources Office.

I certify that the information given by me in this appilcation is true in all respects and that I have not made any willful omissions. I agree to abide by all present and subsequent rules and regulations of JHACH and understand such rules and regulations may be modified at any time, such deemed necessary by JHACH.

I understand that if accepted into the volunteer program at JHACH that I am required to have immunity to Chickenpox, Measles, Mumps, and Rubella. To verify immunity, I must provide the following information to JHACH Employee Health:
     Varivax (Chicken Pox)
           Written documentation with 2 doses of vaccine,
           Laboratory evidence of immunity,
           Diagnosis of history of varicella disease by a health-care provider, or diagnosis of history of herpes zoster by a health-care provider.

     MMR (Measles, Mumps, Rubella
          Born BEFORE 1957: NO DOCUMENTATION NECESSARY
          Born in 1957 or later:
               Proof of immunity includes one of the following:
                    - Two vaccines after 12 months of age.
                                         OR
                    - Laboratory evidence of immunity for Measles (Rubeola), Mumps, and Rubella.

     Tetanus/Pertussis and Diptheria(Tdap)
          
If you have never had a Tdap immunization you should receive a single dose of Tdap from your own doctor before you begin to volunteer.

     Tuberculosis
           A TB screening will be provided by the hospital if your application is accepted.

Immunization/immunity records may be acquired from either your doctor, school, university, or the Public Health Department.

Furthermore, I understand that if selected to volunteer, disclosure of confidential information concerning the hopital or a patient may cause immediate dismissal. By submitting this application, I am agreeing to these requirements as set by the JHACH Volunteer Resources Office.

*I agree to the statement of understanding and agreement. (if you do not agree, your application will NOT be processed)