Academy of Medical & Public Health Services, Inc.

Worldwide

AMPHS National (United States of America)

5306 Third Avenue Brooklyn New York 11220
info@amphsonline.org

APPLICATION INSTRUCTIONS
Application for Volunteer Engagement: Volunteer Staff, Internship, Fellowship, Leadership and
Management
Thank you for your interest in volunteering with the Academy of Medical & Public Health Services, Inc.! We
look 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 & management
positions in the non-profit, the Medical Reserve Corps, the American Heart Association Training Site, the
Institute of Cardiovascular Medicine, the Institute of Emergency Management, the Center for Healthcare
Policy, and the Institute of Nutritional Studies. For specific positions available, please visit our website at
www.amph.co.nr.
Please note that you do not have to be a healthcare professional or hold any current license. We also accept
volunteer 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-time
internship and fellowship positions (can be for academic credit). Please note that you must be a resident of New
York City in order to apply for a full-time, semester-long internship or fellowship. Internships and fellowships
are renewable for subsequent semesters upon the agreement of both you and your supervisor. Short-term
volunteers must volunteer for a minimum of six (6) months.
In addition to completing the application, please attach the following documents to your application to complete
your application packet:
For all applicants:
A copy of your resume / CV
For applicants seeking an internship and/or fellowship position:
A copy of your resume / CV
A copy of your most recent academic transcript
For applicants seeking a leadership and/or 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 mon.yuck.yu@amphsonline.org
For additional information or questions, please contact Mon Yuck Yu, Chief of Staff & Executive Assistant to
the President & CEO, at mon.yuck.yu@amphsonline.org or call (646)388-1398.

Academy of Medical & Public Health Services, Inc. Worldwide

AMPHS National (United States of America)

5306 Third Avenue Brooklyn New York 11220
info@amphsonline.org

APPLICATION TIMELINE
Application for Volunteer Engagement: Volunteer Staff, Internship, Fellowship, Leadership and
Management
Applications are accepted on a rolling basis. The only deadlines that apply are for applicants seeking internship
and fellowship positions. Applications must be received by the respective deadlines.
INTERNSHIP/FELLOWSHIP APPLICATION DEADLINES
Term of Internship/Fellowship

Application Deadline

Internship/Fellowship Start Date

Summer 2010
Fall 2010
Spring 2011

Friday, May 28, 2010

Friday, October 22, 2010
Friday, December 3, 2010

Monday, June 14, 2010

Monday, October 30, 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 an
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 also
bring 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.

AVAILABLE POSITIONS
as of September 2010
The following positions are available at this time.
Leadership/Management Fellowships (for licensed and/or experienced applicants)
Executive Vice President, Personnel Resources
Vice President, Division of Medical Education
Vice President, Division of Community Engagement
Fellowships (for licensed and/or experienced applicants)
Cardiovascular Medicine Fellow (AHA BLS Instructor) Public Health & Epidemiology Fellow
Emergency Management Fellow (FEMA Instructor)
For those licensed to practice medicine in NYS:
Nutritional Studies Fellow
Clinical Medicine Fellow
Internships
Development Specialist
Community Services Associate
National Charters Associate
Program Coordinators
Marketing & Outreach Associate
Corporate Specialist
Non-Profit & Community Specialist
Government Affairs Specialist
Medical Education & Training Associate
Administrative Specialist
Yoga, Tai Chi, Dance Instructor
Medical & Public Health Services Associate

Academy of Medical & Public Health Services, Inc. Worldwide

AMPHS National (United States of America)

5306 Third Avenue Brooklyn New York 11220
info@amphsonline.org

APPLICATION FOR VOLUNTEER ENGAGEMENT

Volunteer Staff, Internship, Fellowship, Leadership and Management
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
________________________________________________
U.S. Citizenship: ____Yes ____No If no, please explain:
PERSONAL
HISTORY
_____________________________________________________
Do
youSecurity
have any
physical limitations? **
____Yes Gender: ____ Male
Social
Number_________________________
Date of Birth _____/____No
_____/_________
____ Female
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 will
remain confidential and will only be used in case of emergency.
DO NOT COMPLETE THIS SECTION FOR OFFICE USE ONLY
Date received: ______ /______/_________ Interview Date: ______ /______/_________ Interviewer: __________________
Accepted: _____ Denied: _____ Date: ______ /______/_________ Signature: ___________________________________
Comments: _____________________________________________________________________________________________

PERSONAL HISTORY
Have you ever been convicted of a felony or misdemeanor? ***

____No ____Yes

If yes, please explain:

______________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
***All applicants are subject to a background screening.

EDUCATION
Highest Level of Education Achieved _________________________________ Diploma
_______________________
Institution ___________________________________ _______________ Date Degree Conferred
______/________
Current Institution _____________________________________________ City/State
________________________

PROFESSIONAL
EXPERIENCE
Program of Study ________________________________________
Degree Expected
_________________________
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.
_________________________________

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.
_________________________________

LICENSES & CERTIFICATIONS

______________________________________________________________________________________________
Please list any current licenses and certifications you posses, the certifying agency, and their expiration dates.
______________________________________________________________________________________________
License/Certification
Certifying Agency
Expiration
Date
______________________________________________________________________________________________
___
_________________________________________ ______________________________
____________________
_________________________________________ ______________________________
____________________
_________________________________________ ______________________________
____________________
_________________________________________ ______________________________
____________________
_________________________________________ ______________________________
____________________
_________________________________________ ______________________________

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 position
per 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 three
positions) and which term(s) you are applying for, if applicable. If selecting multiple positions, RANK the
positions in order from your most desirable position (1) to your least desirable position (3). You may choose
more than one position per volunteer category.
_____ Long-Term (Over 12 months)
months)
____ Volunteer Staff

_____ Short-Term (6 to 12

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

_______________________________________________________________________

____ Internship

_____ Part-Time (Less than 20 hrs/week)

_____ Full-Time (40 hrs/week)
Please list the specific position(s) you want to be considered for:

Term _____________
_______________________________________________________________________

____ Fellowship

_____ Part-Time (Less than 20 hrs/week)

_____ Full-Time (40 hrs/week)
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 /
Management
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 a
professional source. None of the references may be directly related to you in any way. We reserve the right to
contact any and all references listed below.
Reference 1
Title__________ Name ______________________________________ Phone ________________________
Relationship to You _______________________ Email: ____________________________________________
Reference 2
Title__________ Name ______________________________________ Phone ________________________
Relationship to You _______________________ Email: ____________________________________________
Reference 3
Title__________ Name ______________________________________ Phone ________________________
Relationship to You _______________________ Email: ____________________________________________

STATEMENT OF ACKNOWLEDGMENT
By signing this document, I hereby certify that I have read the AMPHS materials and application, and that all
information 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 will
abide by the rules and regulations listed under the AMPHS Code of Conduct, Workplace Policy, and Sexual
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 committee
review.
_______________________________________________________
Signature

__________________________
Date

_______________________________________________________
Print Name

Follow the directions on the Application Instructions for submitting your completed application
packet.

THANK YOU FOR YOUR APPLICATION TO AMPHS NATIONAL.