Junior Application

Prescreening

I am 18 or over and graduated High School.

This application if for those who are at between the ages of 15 and 17. If you are 18 or older and have graduated High School, please click this link to access the Adult Application. Thank you.

I am between the ages of 15 and 17.

Choose Hospital Location

* I acknowledge that not all applicants will be selected.

Personal Information

Name

* First Name

* Middle Initial (Use 'n/a' if you don't have a middle initial)

* Last Name

Preferred Name

Contact Information

Home Phone Number

* Cell Phone Number

* Email Address

Address

* Street Address

Street Address

* City

State

* Zip Code

Birthday Information:

Birth Month

Birth Day

Additional Information

About You

Gender

Current Employer

* Current School?

What grade level will you be entering for the 26-27 academic year?

* What are you hoping to gain from this experience? (200 words or less)

Please take a moment to share any previous volunteer experience(s). (200 words or less)

* Describe a significant challenge, setback or failure you have faced and how did it shape you? (200 words or less)

Any additonal information you would like to share with us. (200 words or less)

How did you hear about Texas Children's Hospital?

Required Documents

Please upload most recent report card (Woodlands, West, and North Austin Campuses only)

* Report Card

Please upload two recommendation forms (Woodlands, West, and North Austin Campuses only ).

* Recommendation Form

Emergency Contact and Physician's Information

* Emergency Contact Name

* Emergency Contact Phone Number

Emergency Contact Relationship

Physician's Name

Physician's Phone Number

Conclusion

Have you ever been convicted of a misdemeanor?

Have you ever been convicted of a felony?

Please list any friends or relatives associated with Texas Children's Hospital (Medical staff, Employees, Board of Trustees, patients or volunteers. Please indicate relationship.