HH College Student Application

College Student Application

Thank you for your interest in volunteering at Hartford Hospital. Please complete all required fields below to establish your applicant profile and apply for a volunteer position. Applications are reviewed by our managers as volunteer roles become available.

We are extremely grateful for the overwhelming interest in volunteer opportunities with our hospital. Because the number of applications we receive often exceeds our volunteer openings, we regret that we are not able to place every applicant.

***Please create your user name and a 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 .

New User Details

User ID

User ID (verify)

Password

Password (verify)

Application Information

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

* Family/last name

* First name

* Street Address

* City

State (as combo)

* Zip/postal

* Home phone

Mobile

Do you speak any additional languages?

* Present School

Highest grade completed

Course of study

* Name of your emergency contact

* Home phone

Mobile

Please check if currently employed

Are you now or have you ever been employed by Hartford Healthcare?

If yes, please select your facility below

Current / Most Recent Employer

Position Held

Supervisor Name

Business Phone

How did you hear about our program?

Volunteers must be able to commit to a minimum of 3 hours per week for 6 consecutive months. Please list your earliest date of availability.

Please tell us which days and times you are available. Check all that apply

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

* What do you hope to accomplish / what are you most interested in doing as a volunteer?

* I understand that documentation of an MMR vaccine, history of chicken pox or varicella vaccine, and a recent Tuberculosis (PPD) test will be required to volunteer at Hartford Hospital

* I understand that flu vaccination is mandatory during flu season.

Which Ethnicity best describes you?

Which Race best describes you?

I hereby authorize Hartford HealthCare, its employees and agents to make recordings of me, whether audio or images, still or moving, and to alter and composite the same without restriction and without my inspection or approval, for use by Hartford HealthCare for any purpose in any and all media now or hereafter known, and to use my name in connection with said use if it chooses. I understand that this consent cannot be revoked, that it is effective in perpetuity, and that I have no expectation of payment in consideration for my authorization. I hereby release and hold harmless Hartford HealthCare, its employees and agents from all claims and liability relating to said recordings. I agree that a copy of this authorization will be as valid as the original.