UW Health Volunteer Application: 16 and 17 Year Olds

New User Details

User ID

User ID (verify)

Password

Password (verify)

UW Health Volunteer Application: Teen (16 and 17 Year Olds)

Personal Information

* First Name

Middle Name 

* Last Name

* DOB (MM/DD/YYYY)

Volunteers will wear a polo shirt while volunteering. Please choose the size of the polo shirt that you would like:

Pronouns are personal and a way for us to show respect and create inclusion. What pronouns would you like the volunteer team use during the application process? Responding to this question is optional and will not affect any volunteering decisions.

* Local Address

Address Line 2

PO Box

* City

County

* State

* Zip Code

* Primary Phone

Secondary Phone

* E-mail

Volunteer Experience

Please explain any past volunteer experience. Example: clubs, church, school, other healthcare organizations, ect.

Please Indicate Any Language(s) Known

Emergency Contact

* Name

* Relationship

* Phone (Mobile)