STUDENT VOLUNTEER APPLICATION - NCH Healthcare System

To perform my duties as an NCH Student Volunteer:
STUDENT VOLUNTEER CONTRACT
1. I will review and abide by the policies and procedures stated in the NCH Healthcare System
Student Volunteer Handbook and Standards of Excellence.
2. I will consider my volunteer assignment as a commitment. If I am unable to work my volunteer
shift, I will arrange for a substitute volunteer who is trained and assigned to the same service
area. If I cannot arrange for a substitute, I will notify the Director/Coordinator of Volunteer
Services within 24 hours in advance of my shift, if possible. I understand that I may be
terminated from the program should I be absent from my volunteer shift two times in a row
without proper notification.
3. I understand and am able to fulfill the requirement to work at least 40 hours for the summer;
volunteering at least three, four-hour shifts a week.
4. I will hold all information as confidential concerning patients, families, staff members, physicians
and volunteers.
5. I will make my service professional in all ways. I will conduct myself with dignity, courtesy and
have consideration for others.
6. I understand that the following may result in immediate dismissal: Breach of confidentiality; Lack
of honesty; Failure to complete work; Personal verbal attacks.
7. I will not make or receive personal phone calls (land line or cellular) or text while volunteering.
8. I understand that only patients are to be seated and/or transported in the hospital wheelchairs.
9. I understand that I must be in compliance with the dress code.
PARENT/GUARDIAN AGREEMENT
1. I understand that the NCH Healthcare System reserves the right to dismiss my child’s services as
a volunteer if the action is in the interests of the hospital and/or my child. Dismissal could result
from failure to comply with hospital rules and regulations or inappropriate personal conduct,
attitude or appearance.
2. I give my consent for my son/daughter to submit this application to join the NCH Healthcare
Student Volunteer Program.
3. I give consent for the NCH Healthcare System to administer to my child and monitor an annual
TB skin test.
SIGNATURES
Parent/Guardian Signature
Student Applicant Signature
Please return completed application and required documents to:
Volunteer Office
Volunteer Office
NCH Healthcare System
NCH Healthcare System
Downtown Naples Campus
North Naples Hospital Campus
350 7 th Street North 11190 Health Park Blvd.
Naples, FL 34102 Naples, FL 34110
(239) 624-3410 (239) 552-7703