Please note: YOU MUST BE A MINIMUM OF 16 YEARS OF AGE TO APPLY.
IN CASE OF EMERGENCY, WHOM SHOULD WE CONTACT?
Tell us about your availability
In order of preference, list departments/programs that most interest you.
See campus specific opportunities at
nyp.org/volunteer.
Employment or Volunteer Experience Information
Please list most current experience first.
Employer/Volunteer Organization #1
Employer/Volunteer Organization #2
If you are currently in high school, please tell us what school you attend.
What college/university do you or did you attend?
Other education, certifications or licenses?
Volunteer Character Reference
APPLICATIONS MUST INCLUDE A COMPLETED VOLUNTEER CHARACTER REFERENCE IN ORDER TO BE REVIEWED.
(Family members should not act as a reference)
I authorize NewYork-Presbyterian Hospital, or any agent it expressly authorizes to act on its behalf, to
investigate fully all the information and references contained on my application for a volunteer opportunity. I
release my current employer as well as former employees and other appropriate references from any liability and
responsibility for providing written or verbal information about me to NewYork-Presbyterian Hospital.
At NYPH our initiatives support our ultimate goal: We Put Patients First. This means that in everything
we do, we must make patients our first priority and strive to provide them with the highest quality, safest,
and most compassionate care and service. How can you help us further this initiative as a volunteer?
Please read the following statements carefully, as they represent matters of importance to you and to
NewYork-Presbyterian Hospital in connection with this volunteer application . After you have read the form in its
entirety, please sign below.
I understand and agree that:
- The information provided in this application, in my resume (if supplied) and during my interview(s) is true and
complete to the best
of my knowledge. I understand that any false or misleading statements on this application, on my resume, on any
prescreening
documents or in my interview(s) will justify refusal of volunteer status or, if I am hereafter on boarded by
NewYork-Presbyterian
Hospital, termination of my volunteer status.
- NewYork-Presbyterian Hospital may verify all of the information that I have provided on this application and I
release NewYork-
Presbyterian Hospital and its representatives from liability for seeking such information and I release from all
liability whatsoever any
and all persons, institutions, business entities, and corporations providing NewYork-Presbyterian Hospital with
such information. I
further agree to sign whatever consent forms may be necessary to permit NewYork-Presbyterian Hospital to verify all
of the
information that I have provided in this application.
- I understand that falsification or omission of information on my application may result in my immediate
dismissal.
- I understand that in accordance with New York State law, if I am offered a volunteer opportunity I will be
fingerprinted and that
such offer and continued volunteering are conditional upon satisfactory clearance by the Hospital's Workforce
Health & Safety
Department, which includes drug testing, and satisfactory reference verification and other general information
provided on this
volunteer application. I understand that if I am offered a volunteer opportunity, my volunteering will be "at
will," meaning that either
I or NewYork-Presbyterian Hospital may end the volunteer relationship for any lawful reason, at any time, with or
without notice.
In consideration of any volunteer opportunity which may be offered to me, I agree to comply with the
policies, rules, regulations and procedures of NewYork-Presbyterian Hospital.
My name typed below will stand as my signature, confirming the completeness and accuracy of the information I provided above, and will carry the same
force and effect as if it were signed and affixed by my hand.
