Thank you for your interest in health education opportunities with Covenant Community Care. 


Please fill out the following application if you are interested in work performed for:

(1) the purposes of training

(2) the fulfillment of a school requirement - this includes preceptorships and medical/dental internships or externships.

Contact Information

State / Province*
Confirm Email*

Volunteer Information

What do you hope to achieve through this experience?
What days and times are you available?
What skills and/or previous experiences do you have that connect with this opportunity?
College/University Currently Attending
What does your school require for this educational experience?
Would you submit to a background check?
  • Yes
  • No
  • Please Contact Me About This Topic
May we send you updates about Covenant?
  • Mail & Email
  • Only Mail
  • Only Email
  • I Don't Want to Receive Updates

Emergency Contact

Please enter the name, address and contact information of someone Covenant can contact in the case of emergency. 

Name, Address & Contact Information
I understand and agree that submitting this application form does not automatically qualify me as a Covenant volunteer, and that there may be other qualifications I must meet, including the acceptance of established volunteer policies and procedures before I may begin shadowing.
  • I Agree
Additional Comments