|How did you hear about us? |
|Prior Volunteer/Internship Experience (include dates) |
|Please describe any experience, special skills or area of interest that will help us determine where you might be best suited as a volunteer/intern for Boston Health Care for the Homeless Program. |
|What do you hope to gain from volunteering/interning with Boston Health Care for the Homeless? |
|Do you speak any languages other than English?
For internships only:
|How many hours per week are you available? |
|Expected length of participation |
|Date you are available to start |
|Do you have a car?
|Please check all of the volunteer/internship opportunities that interest you: |
Foot Care in Medical Clinic |
Waiting Room Hospitality
Leading group activities (art, movies, etc)
Research Support/ Conducting surveys of patients
Reception/ Front Desk Support
BHCHP’s most urgent need
|Ethnicity (optional - for statistical purposes only) |
Black - African-American
Hispanic - Latino
Native American |
Other - please specify
|*In addition to completing this application form, you must also submit two letters of reference from people who know you well (other than family). Emailed references will suffice. Email references may be sent to email@example.com.
**Further, volunteers & interns will also be required to complete the following: Orientation, CORI check, immunization records, any necessary training.
***Please note: Our internship opportunities are customized based on the applicant’s interest, BHCHP’s needs, and open positions. We will do our best to create an internship that is varied and meets your needs, but cannot always guarantee a position.
If you cannot complete this application on line, please feel free to fax to (857) 654-1096 or mail to:
Boston Health Care for the Homeless Program
780 Albany Street
Boston, MA 02118