application for volunteer engagement

8/3/2019 Application for Volunteer Engagement

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Academy of Medical & Public Health Services, Inc. Worldwi

AMPHS National (United States of America) 5306 Third Avenue • Brooklyn • New York • 11220 •

[email protected]

APPLICATION INSTRUCTIONS Application for Volunteer Engagement: Volunteer Staff, Internship, Fellowship, Leadership and

Thank you for your interest in volunteering with the Academy of Medical & Public Health Services, Inc.! Wlook forward to having you on board with us!

Please read and follow the instructions carefully.

AMPHS currently has positions open for volunteer staff, internships, fellowships, and leadership & managempositions in the non-profit, the Medical Reserve Corps, the American Heart Association Training Site, theInstitute of Cardiovascular Medicine, the Institute of Emergency Management, the Center for HealthcarePolicy, and the Institute of Nutritional Studies. For specific positions available, please visit our website atwww.amph.co.nr.

Please note that you do not have to be a healthcare professional or hold any current license. We also acceptvolunteer applications from high school students, college students, and graduate school students.

We offer short-term and long-term volunteer positions as well as semester-long part-time and full-timeinternship and fellowship positions (can be for academic credit). Please note that you must be a resident of NeYork City in order to apply for a full-time, semester-long internship or fellowship. Internships and fellowshipare renewable for subsequent semesters upon the agreement of both you and your supervisor. Short-termvolunteers must volunteer for a minimum of six (6) months.

In addition to completing the application, please attach the following documents to your application to compleyour application packet:

A copy of your resume / CVsition:

A copy of your resume / CV A copy of your most recent academic transcript

management position: A copy of your resume / CV A copy of your most recent academic transcript

We will not review incomplete applications. Late applications will not be considered.

Please email your completed application packet to: Mon Yuck Yu at [email protected]

For additional information or questions, please contact Mon Yuck Yu, Chief of Staff & Executive Assistant to, at [email protected] or call (646)388-1398.

http://www.amph.co.nr/


mailto:[email protected]









http://docs.google.com/a/amphsonline.org/uc?id=0B4vBgdOZq1OcZDZhODcxODgtN2I0NS00ZGNiLTk1YmMtZDkyNDdjNzE0YTdi&hl=en





[email protected]

APPLICATION TIMELINE Application for Volunteer Engagement: Volunteer Staff, Internship, Fellowship, Leadership and

Applications are accepted on a rolling basis. The only deadlines that apply are for applicants seeking internshiand fellowship positions. Applications must be received by the respective deadlines.

of Internship/Fellowship Application Deadline Internship/Fellowship Start Date

Summer 2010 Friday, May 28, 2010 Monday, June 14, 2010Fall 2010 Friday, October 22, 2010 Monday, October 30, 2010Spring 2011 Friday, December 3, 2010 Monday, January 10, 2011

The following is the procedure for volunteering with AMPHS National:

(1) Complete the application and submit the completed application and additional documents.(2) We will contact all eligible applicants* within a week of the submission of the application to schedule a

interview. Interviews will be 30 minutes to an hour, depending on the position you are applying for.(3) Please bring a copy of all your certifications and licenses, and any additional supporting documents to

your interview. Applicants for leadership/management and administrative intern positions should alsobring a writing sample to the interview.

(4) Shortly after your interview, we will inform you if you have been accepted to a position.(5) If accepted, complete any required training(s) pertinent to your position and pass any required

examinations.(6) Get your AMPHS ID, and begin volunteering!!!

*Eligibility may be determined by successfully passing a background check for criminal history and a follow-up with

references listed on your application.

The following positions are available at this time.

t Fellowships (for licensed and/or experienced applicants) Executive Vice President, Personnel ResourcesVice President, Division of Medical EducationVice President, Division of Community Engagement

(for licensed and/or experienced applicants) Cardiovascular Medicine Fellow (AHA BLS Instructor) Public Health & Epidemiology FellowEmergency Management Fellow (FEMA Instructor) For those licensed to practice medicine in NYS: Nutritional Studies Fellow Clinical Medicine Fellow

Development Specialist Community Services AssociateNational Charters Associate Program CoordinatorsMarketing & Outreach Associate Corporate SpecialistNon-Profit & Community Specialist Government Affairs SpecialistMedical Education & Training Associate Administrative SpecialistYoga, Tai Chi, Dance Instructor Medical & Public Health Services Associate

AVAILABLE POSITIONSas of September 2010






[email protected]

APPLICATION FOR VOLUNTEER ENGAGEMENTVolunteer Staff, Internship, Fellowship, Leadership and Management

DO NOT COMPLETE THIS SECTION – FOR OFFICE USE ONLY

Date received: ______ /______/_________ Interview Date: ______ /______/_________ Interviewer: _______________

Accepted: _____ Denied: _____ Date: ______ /______/_________ Signature: _________________________________

Comments: ___________________________________________________________________________________________

Thank you for your interest in volunteering with the Academy of Medical & Public Health Services, Inc.Please fill out the following application and submit it according to the Application Instructions.

PERSONAL INFORMATION

Last Name ____________________________________ First Name________________________________________

Address________________________________________________________________________________________________

City _________________________________________ State ____________________ Zip Code_________________________

Day Phone (________)___________-___________________ Evening Phone (________)___________-

___________________

Cell Phone (________)___________-___________________ Email________________________________________________

PERSONAL HISTORY

Do you have any physical limitations? ** ____No ____Yes

If yes, please explain:______________________________________________________________________________________

_____________________________________________________________________________________________________

Do you have any medical conditions and/or limitations? ** ____No ____Yes

If yes, please explain:

______________________________________________________________________________________

_____________________________________________________________________________________________________

**Please note that your responses to these questions will in no way affect your eligibility for a position. All responses wremain con idential and will onl be used in case o emer enc .




PERSONAL HISTORY

Have you ever been convicted of a felony or misdemeanor? *** ____No ____Yes

f yes, please explain:_____________________________________________________________________________________

____________________________________________________________________________________________________

____________________________________________________________________________________________________**All applicants are subject to a background screening.

EDUCATION

Highest Level of Education Achieved _________________________________ Diploma______________________

nstitution ___________________________________ _______________ Date Degree Conferred_____/________

Current Institution _____________________________________________ City/State_______________________

PROFESSIONAL EXPERIENCE

Organization__________________________________________________________________________________

ndustry ______________________________ Your Position/Role_______________________________________

Nature of Position? ____ Volunteer ____ Paid Dates of Involvement _________________ to________________

Please provide a brief description of what you learned from this experience.________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

Organization__________________________________________________________________________________

ndustry ______________________________ Your Position/Role_______________________________________

Nature of Position? ____ Volunteer ____ Paid Dates of Involvement _________________ to________________

Please provide a brief description of what you learned from this experience.



LICENSES & CERTIFICATIONS

Please list any current licenses and certifications you posses, the certifying agency, and their expiration dat

License/Certification Certifying Agency ExpirationDate

_________________________________________ __________________________________________________

_________________________________________ __________________________________________________

_________________________________________ __________________________________________________

_________________________________________ __________________________________________________

_________________________________________ __________________________________________________

PROFESSIONAL EXPERIENCE

Organization___________________________________________________________________________________

Industry ______________________________ Your Position/Role________________________________________

Nature of Position? ____ Volunteer ____ Paid Dates of Involvement _________________ to

_________________

Please provide a brief description of what you learned from this experience._________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

Organization___________________________________________________________________________________

Industry ______________________________ Your Position/Role________________________________________

Nature of Position? ____ Volunteer ____ Paid Dates of Involvement _________________ to_________________

Please provide a brief description of what you learned from this experience.



LANGUAGE SKILLS

Please list any languages skills you possess and the proficiency level of each.

Language Read, Write, Speak, or All Proficiency Level (Fluent, Intermediate

Conversational)

_______________________________ _____________________ ____________________________________

_______________________________ _____________________ ____________________________________

ADDITIONAL SKILLS & TRAINING

Please list any additional skills and trainings you have.

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

HONORS & AWARDS

Please list any honors and awards that you have received in the past four (4) years.

Honor/Award Year

______________________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

VOLUNTEER AVAILABILITY

Please describe your availability in terms of the day(s), time(s), and hour(s) you can commit to this positionper week.

Day(s) Available to Volunteer:______________________________________________________________________

Time(s) Each Day:_______________________________________________________________________________

Total Hours Per Week: _____________ Additional Comments:



POSITION OF INTEREST

Please select which position you would like to be considered for (you may select a maximum of threepositions) and which term(s) you are applying for, if applicable. If selecting multiple positions, RANK thepositions in order from your most desirable position (1) to your least desirable position (3). You may choosmore than one position per volunteer category.

_____ Long-Term (Over 12 months) _____ Short-Term (6 to 12

months)____ Volunteer Staff Please list the specific position(s) you want to be considered for:

_____________________________________________________________________

_____ Part-Time (Less than 20 hrs/week) _____ Full-Time (40 hrs/week____ Internship Please list the specific position(s) you want to be considered for:

Term ____________________________________________________________________________________

_____ Part-Time (Less than 20 hrs/week) _____ Full-Time (40 hrs/week____ Fellowship Please list the specific position(s) you want to be considered for:

Term ____________________________________________________________________________________

Please list the specific position(s) you want to be considered for:____ Leadership /

STATEMENT OF INTEREST

Please discuss why you are interested in volunteering for AMPHS National.

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________



REFERENCES

Please list three references. One reference must be an academic source, and one reference must be aprofessional source. None of the references may be directly related to you in any way. We reserve the righcontact any and all references listed below.

Reference 1

Title__________ Name ______________________________________ Phone ________________________

Relationship to You _______________________ Email: ____________________________________________

Reference 2

Title__________ Name ______________________________________ Phone ________________________


Reference 3

Title__________ Name ______________________________________ Phone ________________________


STATEMENT OF ACKNOWLEDGMENT

By signing this document, I hereby certify that I have read the AMPHS materials and application, and that

nformation submitted in connection with my application is true and correct. I understand that AMPHS

retains the right to verify any of the information submitted in support of my application, and that my

application is subject to immediate dismissal upon omission, misrepresentation, or concealment of any

significant fact in the submitted materials. I further certify that if I am granted a position with AMPHS, I wabide by the rules and regulations listed under the AMPHS Code of Conduct, Workplace Policy, and Sexua

Harassment Policy. I also agree to complete all required trainings as soon as they are available, and am fully

aware that I must attend all training sessions that are required of me, without exceptions. I understand and

agree that violation of any of these provisions succeeding enrollment will bring my position under committ

review.

_______________________________________________________ __________________________Signature Date

_______________________________________________________Print Name

Follow the directions on the Application Instructions for submitting your completed applicationpacket.

THANK YOU FOR YOUR APPLICATION TO AMPHS NATIONAL.

application for volunteer engagement

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