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Volunteer Services - Teen Application

Teen Application for Volunteer Services

Thank you for your interest in volunteer opportunities at MD Anderson Cancer Center. Please take a few minutes to complete our Teen Application. You will be contacted by a staff member in the Department of Volunteer Services only if there is a position that matches your interests, skill and availability.

* Indicates required field.

Personal Information
Parent/Guardian Information
*Does your Mother work at MD Anderson?:
*Does your Father work at MD Anderson?:
School Information
Volunteer Information
*Select a Volunteer Program?:

Explain why:
1000 character limit.
Health Questionnaire
In case of an emergency, please notify:
*Have you had any serious health condition that would keep you from volunteering?

*Are you currently under a doctor's care for ongoing treatment that we should be aware of?

MMR (measles, mumps,rubella)
Small Pox
Poliomyelitis (polio)
*Have you ever had or do you now have any of the following?:
Chicken pox  
Dizziness or fainting spells  
Pain in chest, palpitations  
Backaches or back surgery  
Herpes zoster (shingles)  
Skin infections, rash or boils  
Shortness of breath  
High blood pressure  
*Are you under medication?:
*Are you taking any medications of which we should be aware?:

By clicking submit, I hereby certify that the above is true and complete to the best of my knowledge. I realize this information is confidential and may be used to determine my eligibility to volunteer. I authorize M. D. Anderson Cancer Center to make an inquiry to my physician regarding the state of my health. I agree to submit to examinations which may include chest x-rays, appropriate laboratory tests and/or immunizations which may be necessary as part of my volunteer service. I also authorize the person(s) making tests or x-ray films to report the results to Employee Health Services.