UNC Health Nash Foundation Junior Volunteer Application

UNC Health Nash Foundation

Junior Volunteer Application
Volunteer Information

Applications are due by 5pm on Friday, March 6, 2026.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Date of Birth*

MonthDayYear
Date
Age*
School*
Graduation Date*

MonthDayYear
Date
Have you volunteered here before?*
Are you related to, or do you have a close personal connection with, a UNC Health Nash team member?*

YesNo
If yes, please provide the team member's name, department, and your relationship:*
Volunteering at UNC Health requires responsibility, reliability, and a willingness to help others. Please respond to the questions below in one complete essay . Upload your response using the drag and drop box below.(Required)*
1. Describe a time when you helped someone or took responsibility for a task (at school, home, church, sports, or in your community).
2. What was your role, and what did you learn from that experience?
3. How do you think this experience has prepared you to volunteer in a healthcare setting?
Writing Guidelines & Expectations:
- Responses should be thoughtful, honest, and written in your own words.
- Use specific examples and complete sentences
- Maintain a respectful and professional tone
- Applications with incomplete responses or copied content may not be considered.
Cancelof
I understand that I must be available to volunteer ONE full day a week (9AM-4PM) and attend a two-day orientation.*

Clear

Parent/Guardian Information
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Number*
Please enter a valid phone number.
Work Number
Please enter a valid phone number.
Email*
example@example.com
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Number
Please enter a valid phone number.
Work Number
Please enter a valid phone number.
Email
example@example.com
Emergency Contact Information

In case of emergency, notify parent or guardian listed above or:
Name

First NameLast Name
Cell Number
Please enter a valid phone number.
Email
example@example.com
Relationship to volunteer

Junior Volunteer Vaccine Questionnaire
Do you have a vaccine record with verification of two MMR vaccines?*
If no, please contact your personal physician to get an MMR titer to verify immunity.
Have you had chicken pox or the chicken pox vaccine(varicella)?*
If you have no history of the disease and haven't been vaccinated for it, please contact your personal physician to get a chicken pox (varicella) titer to verify immunity.
Have you had a TB skin test in the past?*
If yes to the above, please put the date.

MonthDayYear
Date
Have you ever had any reaction to a TB skin test?*
If answered yes to the above, please explain.
TB skin tests are MANDATORY for all employees, contract staff, and volunteers at UNC Health Nash.

If your child has not received a TB skin test in the past 12 months, please sign the consent below.
*Applicants are required to submit all current immunization records to Occupational Health during your scheduled visit.

I authorize UNC Health Nash's Occupational Health office to administer an initial TB skin Test and a 2nd test, if necessary and to collect a urine specimen for drug screen testing for:
Junior Volunteer Name

First NameLast Name
Age
Parent/Guardian Name

First NameLast Name
Parent/Guardian Signature

Clear
Date

MonthDayYear
Date

Junior Volunteer Reference Information
Please provide contact information for TWO professional or academic references in the online application. This means a current teacher, counselor, employer, etc. Family members, neighbors, and family friends are NOT appropriate references. These references may be contacted in the spring to determine your placement in the program.

Chenoa Davis will contact the reference and give them the necessary paperwork.
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.

Applicant Agreement
I hereby certify that the answers on this application and any resultant interviews are true and correct, and that misrepresentations or omission of facts, misleading or false information on my part will be grounds for dismissal as a volunteer.

Acceptance as a Junior Volunteer is contingent upon satisfactory references, selection from the interview process and verification of the information submitted on this application. I, therefore, authorize you to make such investigations and inquiries as you deem necessary in arriving at a decision. I acknowledge and agree that I am not obligated, if called upon, to perform the volunteer services herein applied for, and UNC Health Nash Volunteer Services is not obligated to assign or actively seek to assign volunteer services for me.

I authorize that all employers, schools, or references thus contacted be released from all liability in answering inquiries related to my application.

Opportunities for Junior Volunteers are provided without regard to race, gender, religion, national origin, sexual orientation, or disability. Junior Volunteers must meet minimum age requirement of 14 years old and completed freshman year of high school.
Applicant Signature*

Clear
Shirt Size*
Parent/Guardian Signature*

Clear
Date*

MonthDayYear
Date
Please tell us if you have interests in a specific department.
Should be Empty:

UNC Health Nash Foundation

Volunteer Information

Parent/Guardian Information

Emergency Contact Information

Junior Volunteer Vaccine Questionnaire

Junior Volunteer Reference Information

Applicant Agreement