***AFTER SUBMITTING YOUR APPLICATION*** You will receive immediate email confirmation, please check your Bulk or Junk email folder.

NOVAS High School Student Pre-Application Form

VOLUNTEER SERVICES DEPARTMENT, TORRANCE MEMORIAL MEDICAL CENTER

Hours: Monday-Friday, 7:30am-6:00pm

Office (310) 517-4752 Email: HIGHSCHOOLSTUDENTPROGRAM@TMMC.COM

NOVAS Pre-Application Form

If you have any questions, please contact your NOVAS advisor. Thank you
BASIC INFORMATION
Last Name
First Name
Middle Name
DOB
Gender
Home Address
City
State
Zip Code
E-mail Address
Student's Home Phone
Student's Cell Phone
School
Class of
Grade Level At Time of Orientation
Select Program of Application
GUARDIAN/ PARENT INFO
Contact name
E-mail
Home phone
Mobile
Work phone
Emergency Contact
Contact name
Relationship
Mobile
Home phone
Work phone
E-mail
BACKGROUND

Please give us the name(s) of family and friends that either work or volunteer at Torrance Memorial Medical Center. (Include full name(s), title and department in which they work or volunteer, also, please specify their relationship to you in the drop down list below. If you are not in relationshjp with a Torrance Memorial employee, it is no problem, please simply select "none" in the drop down below..

TMMC Reference Relationship
Why do you want to volunteer at Torrance Memorial Medical Center?
Please select 3 shift preferences for the coming semester (in order of priority)
#1 Preference- Schedule Availability
#2 Preference- Schedule Availability
#3 Preference- Schedule Availability

Please refer to the website for the date on which acceptance notifications will be emailed. PLEASE NOTE: WE ONLY ACCEPT PRE-APPLICATIONS ONLINE