Summer Student Program Application

Please fill out the application below to begin the process. Please note that all volunteers must be vaccinated for COVID-19 and must receive a flu vaccine yearly. If you are 18 or over, we will be conducting a criminal background check, fingerprinting and a drug (urine) screening as part of the onboarding process.

New User Details

User ID

User ID (verify)

Password

Password (verify)

PLEASE NOTE: All Summer Student Program applicants must be 16 by June 1, 2024. All volunteers must provide proof of being fully vaccinated for COVID-19.

Personal Information

Title

* First name

Middle name

* Last name

* Street address

* City

State

* Zip/postal

* Phone

* E-mail

Volunteer Interest

Choose up to 3 jobs you are interested in volunteering.

Choose open schedule job 2

Choose open schedule job 3

Please write a sentence or two explaining why you are interested in participating in the Summer Student Volunteer Program.

Have you ever worked or volunteered for The MetroHealth System?

If yes, indicate the facility, your position, and dates of service:

References

Please list two persons we may contact for a personal reference. Do not list relatives.

Name

Phone

Street address

City

State

Zip/postal

Name

Phone

Street address

City

State

Zip/postal

Employment/Education/Volunteer Experience

Employment Status

Employer

Position

Start Date

I am a student.

School

Volunteer Experience

Describe your present/past volunteer experience, including name of organization, type of assignment, and dates:

Miscellaneous

1) Are you receiving an Ohio Public Employees Retirement System (OPERS) disability benefit?

Person to be contacted in case of emergency

Name/Relationship

Phone

Volunteers under the age of 18

Under Age 18

Minor date of birth

If you are under 18 your parent or guardian must read and sign this statement.

I give my permission for my son/daughter to volunteer for The MetroHealth System. I verify that my son/daughter has not been convicted of any felonies or misdemeanors.

Date

Parent or Guardian Name

Acknowledgement and Signature

I certify that all the information on this form is true and accurate, I understand that all application information will be verified and that false statements or omissions will be considered grounds for immediate dismissal, no matter when such information is discovered or reported to The MetroHealth System. I understand that if I volunteer, I must become familiar with and abide by all the policies of The MetroHealth System. I further understand that my volunteering is conditional upon satisfactory completions of reference and background checks, as well as drug screening. Certain conditions would not apply if the volunteer is a minor.

* Applicant Name

* Application date

By submitting this form, I attest that the information I have provided is true and accurate.

* I Agree

[ clear ]

Signature of Applicant, if minor Parent/Legal Guardian Signature. Please use your mouse for finger to sign.

Existing Volunteers