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VolunTeen application

General information
(Include area code, no dashes)
Vaccination requirement

It is required that you submit your vaccination documents within five business days for your application to be processed

Please mail your records to the address below, fax it to 785-587-5416 or email to crystal_bryant-kearns@mercyregional.org.  

Mercy Regional Health Center
Volunteer Services
1823 College Avenue
Manhattan, KS 66502

Parent/guardian information

Applicants under 18 years of age must obtain parental consent

Please download and complete the parental consent form granting you permission work within various hospital departments. They also should be aware that you may at times be in contact with patients and that this is a volunteer activity and is performed at the participant’s own risk.   

Once filled out, please mail it to the address below, fax it to 785-587-5416 or email to crystal_bryant-kearns@mercyregional.org.  

Mercy Regional Health Center
Volunteer Services
1823 College Avenue
Manhattan, KS 66502

Emergency contact
Education
Please provide you current semester's grade report.
Files must be less than 2 MB.
Allowed file types: gif jpg pdf doc docx.
(Clubs, sports, hobbies, etc.)
Placement and scheduling
A.M.P.M.EVE.Not Available
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Saturday