• Thank you for applying to Rome Memorial Hospital’s Student VolunTeen Program.

    In order to be accepted, please follow the following steps:

    1. You must be between the ages of 15 and 19 by June 20th, to APPLY.
    2. Complete the online application by Friday, May 19th, 2017, 4 pm.
    3. Print out the guidance counselor form and have the counselor return to me by Friday, May 19th, 2017. This is a mandatory piece of information for acceptance into the program.
    4. Print the parental agreement. Read and have your parent sign and send, scan or fax to my information listed below.
    5. When you come for the group interview, please bring with you:
    Your immunization record, showing that you have had 2 MMR’s (measles/mumps/rubella)
     Your working papers if you are under the age of 18. (These may be obtained from your school nurse)
     A physical done within 1 year or a statement from your doctor saying you are free of communicable disease and volunteering will not harm your health. Sports physicals WILL be accepted.

     Proof and result of TB Mantoux test done within 1 year. (this may be done at your doctor’s office)

    Please mail/scan/fax or bring all of the above to:

    Rome Memorial Hospital
    Volunteer Department
    1500 North James Street
    Rome, New York 13440
    Attn: Julie Chrysler
    Phone #: 315/338-7134
    Fax# 315/338-7526
    jchrysler@romehospital.org

    Online Application Link

     

    Required Forms