Thank you for your interest in Watertown Regional Medical Center (WRMC)!
 
Note: If you are interested in applying for employment at Watertown Regional Medical Center, please return to the www.watertownregional.com webpage.
 
This application is intended for persons who are:

1. Interested in a one day job shadow to explore a future career 
2. Interested in volunteering.
3. Interested in an internship to complete a course of study/ college degree at a WRMC facility.

  
Application
Below you will find an application with details including any pre-requisites, considerations for determining appropriate applicants and requirements for participation. This information will enable our Human Resources team to determine eligibility for an experience within our organization.

This application and all requirements must be fully completed to be considered for an experience.
 
For more information on completion of requirements, please reference the "Student FAQ's" at this location http://www.watertownregional.com/work-at-wrmc/student-faqs
 
1. Interested in a one day job shadow to explore a future career AND meets one or more of the following prerequisites:
a.      Applicant is a current employee or volunteer of WRMC.
b.      Applicant is an immediate family member of a current employee of WRMC.
c.      Applicant is a student who has been accepted into or enrolled in a program that requires a job shadow.

Requirements for consideration and participation:
-Complete this survey application
-If accepted, applicant will receive and must read and acknowledge provided orientation materials and attest to HIPAA compliance
-Fulfill any other requirements as requested by the organization.
  
2. Interested in volunteering.

Requirements for consideration and participation:
-Complete this survey application
-Provide documentation of one-time MMR vaccine, Hepatitis B, Tetanus, Varicella, Diphtheria and TB Skin Test within the past 12 months.
-Provide documentation of 5-Panel Urine Drug Screen within the past 6 months.
-Provide documentation of a Completed and Signed Background Check.
--If accepted, applicant must attend Organizational Orientation class as scheduled.
-Fulfill any other requirements as requested by the organization.
 

 3. Applicant is enrolled in and seeking an internship to complete a course of study/ college degree. 

Requirements for consideration and participation:
-Complete this survey application.
-Provide documentation of one-time MMR vaccine, Hepatitis B, Tetanus, Varicella, Diphtheria and TB Skin Test within the past 12 months.
-Provide documentation of 5-Panel Urine Drug Screen within the past 6 months.
-Provide completed and Signed Background Check.
-If accepted, completion of online e-learning Orientation courses prior to start of student experience. Access and instructions will be provided upon acceptance into program.
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* 1. First Name

* 2. Middle Name

* 3. Last Name

* 4. Date of Birth

* 5. Address

* 6. City

* 7. State

* 8. Zipcode

* 9. Email Address

* 10. Home/ Mobile Phone

* 11. Emergency Contact Name, Relationship to you and Phone Number

* 12. Tell us about yourself: In the field below, please describe yourself and why you are interested in an experience at Watertown Regional Medical Center.

* 13. Name of School/ College/ University

* 14. Grade/ Year in School/ College/ University

* 15. Requested Start Date (For a Job Shadow or Internship Experience only)

Note: Due to our commitment to Patient Centered Care and the resources required to provide this type of experience,  Watertown Regional Medical Center requires at least a month's notice prior to scheduling a student experience.

* 16. Please choose one of the following types of experiences:

* 17. If you are under 18 years of age, a parent or guardian must give permission for participation in an experience at Watertown Regional Medical Center.

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