Amigos de UCLA Volunteer App. Spring 2020
Welcome to Amigos de UCLA! Please fill out this application and submit it by Sunday, March 5, 2020 at 11:59 pm.

Training will take place Week 2 of Winter Quarter during the site time of the day you select (location TBD). Site will begin Week 3 and run through Week 9. We meet at the flagpole by Kaplan Hall @ 2:15pm and arrive back to UCLA by 6:00pm. If there are any additional questions please feel free to email us at amigosdeucla@gmail.com. Thanks for considering Amigos!

Sincerely,
The Amigos de UCLA Directors
Name *
First and Last
Your answer
Student ID# *
Your answer
Phone Number *
(XXX) XXX-XXXX
Your answer
Email Address *
Your answer
Year in School *
Are you a new or returning volunteer? *
Why do you want to be a part of Amigos? *
If you are a returning volunteer, please explain why you would like to return.
Your answer
There are many ways to give back to the community, why do you specifically want to work with Amigos de UCLA? *
Your answer
Have you been TB tested in the last two years? *
If you do not have a TB Test:
All volunteers in LAUSD are required to show proof of a tuberculosis test. If you do not have an up-to-date immunization (within the past 3 years), please visit the Ashe Center. You can do a walk-in appointment at the first floor of Ashe Center. Please be pro-active in ensuring you have a copy of your test results before site begins.
Emergency Contact (Name & Phone Number) *
Your answer
Waiver of Liability *
In case of emergency, I authorize Amigos de UCLA staff to take me to the nearest emergency facility and for them to administer the treatment necessary for my safety and protection. I understand that Amigos de UCLA has no insurance covering such medical or hospital costs, and therefore, any cost incurred for such treatment shall be my sole responsibility. Amigos de UCLA nor the University of California will not compensate, insure or indemnify you for any incident, loss of property, illness or injury that may occur during the activity.
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