Advocate Christ Medical Center
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Teen Volunteer Application (14 to 17 years old)

Please make sure that your parent/guardian also fills out this form as well, to be considered.

* Indicates required information
Email Address 
Street Address 1 
Street Address 2 
Phone number 
Date of birth (MM/DD/YYYY) 
Parent/Guardian's Name 
Parent/Guardian's Phone Number 
Gender * 
High School Name 
Current Year * 

Are you looking to satisfy service hours through volunteering? * 

If yes, how many? 
Are you in other school/after school activities? 

If Other, please specify:

Are you currently employed * 

If yes, what is your employer's name? 
How many hours do you work a week? 
Service/Area of Interest * 

Days of Availability * 

Hours of Availability * 

If Other, please specify:

Authentication * 

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  • I realize that without my full support the Volunteer Services Department of Advocate Christ Medical Center will not be able to fulfill its purposes of providing volunteer services in the hospital and promoting health and welfare in the community, I therefore agree to the following:
  • I will volunteer a minimum of (2) to (4) hours a week. I understand that there is a 32 hour minimum requirement to be considered for personal or professional references.
  • I will take any problems, criticisms, or suggestion to the Coordinator of Volunteer Services.
  • I will consider all information which I may hear directly or indirectly concerning a patient doctor, or any member of the hospital personnel, as confidential. I will not seek information regarding a patient.
  • I will uphold the tradition and standard of Advocate Christ Medical Center and abide by all Advocate Christ Medical Center confidential and security policies and procedures and adhere to the Behavior of Excellence.
  • I will notify the volunteer office if I am unable to be present for my shift. I understand that 3 misses without an excused absence will result in termination from the volunteer program.
  • I understand that I am required to complete a health information form and take a 2 step PPD skin test for Tuberculosis prior to starting as a volunteer.
  • I understand that all volunteers are required to receive annual PPD skin tests for Tuberculosis as well as influenza vaccinations.
  • I will wear a designated uniform while serving as part of the ACMC team, following the appropriate dress code guidelines as discussed in the volunteer orientation. I will wear my ID tag at all times while on the medical campus.
  • If I am assigned to a department or area and that requires me to have access to a computer, I will only use the computer for the work described in the job description I am given and not for personal use.(i.e. Internet, Music, Games, e-mail, etc.)
  • I understand that cell phones, I-Pods and all other electronic hand held device are not to be taken with me to my work area and are only permitted in designated areas when I am on break or lunch. I further understand that any violation of this policy will mean immediate dismissal.
  • I understand that Smoking is not permitted anywhere on the medical center campus and that intoxicating beverages or illegal drugs should not be consumed prior to reporting on duty. I further understand that violation of any of these restrictions will mean immediate dismissal.

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