Youth Volunteer Application

Volunteer Application - Youth

Personal Information

First
Last
Address
Address
City
State/Province
Zip/Postal
(otherwise, JGS Lifecare will assign adult to accompany you)
Is your volunteering part of a community service requirement?
(Please provide required authorization form)
Do you smoke (use tobacco products or E-Cigarettes)?
JGS Lifecare is a “smoke-free” campus and no longer hires employees or volunteers who smoke.
How often would you want to volunteer?
Times available

Please check off any of the areas below that interest you.

(Jewish Nursing Home = JNH; Ruth’s House Assisted Living = RH; Adult Day Health = WADH)
Interests

Personal References

(Teacher, Employer, Administrator, Family Friend)

JGS Lifecare, Corp. has my permission to contact references.

Signature