HR - Special Category Episodic Associate Application

Thank you for your interest in participating in the Special Category Program at Children's National Hospital, as an Episodic Associate. Children's National Hospital is an Equal Opportunity Employer. We consider applicants for all positions without regard to race, color, religion, creed, national origin, age, disability, sex, pregnancy/childbirth or related medical conditions (including location), sexual orientation, marital status, genetic testing or information, or any other legally protected status. Individuals with a disability who wish to request assistance or an accommodation in order to apply for a position with should notify Special Category at the time of application.

You must be at least 15 years of age, during the submission of this application; to be considered for a role. You must fully and accurately complete the Application for an Episodic experience. Incomplete applications will not be considered.

Please note one of the following: 1) You must have confirmed the Episodic assignment you are applying for with a Children's National Employee (who will serve as the Supervisor of your assignment) before submitting this application. 2) Have the understanding that Special Category is not obligated to match place you for an assignment.

New User Details

User ID

User ID (verify)

Password

Password (verify)

Application Information

* First Name:

* Last Name:

Middle Name:

Have you ever used any other names that we need to know for us to verify your employment or education records?

Chosen Pronouns:

* Email Address:

Home:

Work:

Cell:

Are you a US Citizen?

Do you have an international address?

* Street Address 1:

Street Address 2:

* City:

State:

* Zip:

* International Address:

* Country

Languages:

* Date of Birth:

Are you at least 15 years of Age?

Are you a former CNH volunteer/employee?

Children's National Dept Information

Please enter the department you will be conducting your Episodic assignment with; as well as contact information for your Children's National Supervisor.

* Supervisor Full Name

* Supervisor E-mail

* Children's National Department

Children's National Hospital Confidentiality, Liability and General Policies Commitment and Agreement for Episodic Associates agrees to the following rules and regulations regarding participation from (Start Date Below) to (End Date Below).

Please note that these dates must fall within a period of five consecutive days.

Start Date:

End Date:

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