HSS Volunteer Application

Please make sure to complete all fields before submitting.

New User Details

User ID

User ID (verify)

Password

Password (verify)

Personal Information

* Family/last name

* First name

Middle name

* Home Address

Line 2/Apartment Number

* City

State

* Zip

Phone (Home)

* Phone (Mobile)

* E-mail

* DOB

* How were you referred to HSS?

Have you been a Patient of HSS?

Are or have you ever been an Employee of HSS?

Have you been Volunteer of HSS?

* Emergency Contact

* Cell Phone

Phone (Home)

Do you have any physical, mental or medical condition, which would limit your ability to perform functions of a volunteer job?

* If yes, please describe.

Educational Background

Have you attented or are currently attending any high school, college, graduate school, or any other training programs?

* Please indicate high school, college, graduate school, or other training programs you are currently attending or have attended.

* Where was your school located?

Are you required to volunteer?

* If yes what is the reason?

* Resume Upload

* Cover Letter Upload