Children's Medical Center Red Balloon Network Adult Volunteer Application

Thank you for your interest in volunteering at Children's Medical Center Red Balloon Network. Please complete this application in order to be considered for a volunteer position.

Once you complete the form, click the continue button at the end of the application.

If you have questions about the application, please contact the Volunteer Services Department at 214-456-2425 or redballoonnetwork@childrens.com.

New User Details

User ID

User ID (verify)

Password

Password (verify)

Contact Information

As a reminder, we will use email as our primary method of contact. Please make sure to provide a current email address.

Title

* First Name

* Last Name

Preferred Name

* Home Address

* City

* State

* Zip Code

Preferred Contact Phone

Home phone

Mobile phone

Work phone

* E-mail address

Educational Status

Education

School/University

Demographic & Personal Information

* Date of Birth

Gender

Marital Status

Work Status

Volunteer Experience

Employer

Position

Title

Background Check & Felony Conviction

Children's Health requires every volunteer applicant to submit to a background check prior to service and on an annual basis.
Applicants seeking to perform court mandated service will not be considered.

Have you been convicted of a felony or misdemeanor (including pleading guilty and no contest)?

Availability

Red Balloon Availability

Production Experience

Tell us about your production and broadcast experience (courses taken, school projects, jobs).

Production Skills

What broadcast and production skills are you most interested in developing? Tell us about how these will fit into your career goals.

Working with Kids

What experience do you have working with children?

References

Please provide contact information for one professional or academic reference. This should be the person who is writing your letter of recommendation.

Reference #1

* First Name

Middle Name

* Last Name

Nickname

* Preferred Contact phone

Work phone

Cell phone

Email address

Relationship

Emergency Contact Information

Please list name and phone number(s) of an emergency contact.

* Contact name

* Relationship

* Phone (Preferred phone)

Home phone

Mobile phone

Work phone

Connection to Children's Health

Please tell us about any personal connections you have with Children's Health or it's employees. If you have family members or friends who are employees or volunteers, please list their name(s) and department of service.

Application Agreement

I understand adult volunteers must be at least 18 years of age and not enrolled in high school, agree to serve in a regular placement over six consecutive months and provide all necessary health information prior to volunteering.

I affirm that the information provided in this application is true and complete. Falsification of any information can result in immediate dismissal from the Volunteer Services Department.

I hereby give my permission and authorize representatives of Children's Health to investigate any or all of the statements I have made in this application.

I understand that this application does not guarantee avolunteer placement at Children's Health.

I further understand that as a volunteer, I may not accept payment for my service and that I will incur the cost of the volunteer uniform and transportation.

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E-Signature