Legal Studies 400 Fall 2019 Application
This application is for Legal Studies 400 course, which will be held on Wednesdays from 3:30-5:00pm (Earn 3 credits, volunteer 6 hours per week). Students accepted will volunteer at either Northeast Family Medical Center and/or Wingra Family Medical Center through the Community Resource Navigator Program. If you have questions while filling out this application please contact


APPLICATIONS ARE DUE BY 9:00AM on Tuesday, March 26th.
Selected students will be invited to enroll by Wednesday, March 27th.
Enrollment deadline: 9:00AM on Monday, April 1st.
Waitlisted students will be contacted after April 1st if seats become available.

Minimum Age/Education: 18 or older, junior standing or higher (by Fall 2019)

Time commitment:
Minimum of 6 hours of volunteering per week, and weekly seminar (Wednesdays from 3:30-5:00pm) (Both required)

UW Health Volunteer Health Screen*
Complete Employee Health Services (EHS) in-person screening by May 17. This might take at least month to complete so you should start right away upon acceptance.

Training Required:
IN PERSON - Wednesday, September 4th from 3:30 pm - 9 pm (dinner included).

Online - UW Health Volunteer Orientation online - complete by May 17
- UW Madison HIPPA Training - complete by May 17
- UW Madison Human Subject Training - complete by May 17
- Mandated Reporter Training - complete by May 17

If you need additional immunizations, please check in with Employee Health Services (EHS) for the sequence.

If you cannot finish everything by the dates listed you will not be able to participate, no exceptions.

I am available to visit Employee Health Services in person at least 4 weeks before the screening deadline (which is May 17th). *
I am available on September 4th for the required in-person training from 3:30 pm to 9 pm. *
I understand that I need to complete all required online trainings and complete the in-person health screening process before May 17. *
I have read and fully understand all the information above. *
Never submit passwords through Google Forms.
This form was created inside of UW-Madison Center for Patient Partnerships. Report Abuse - Terms of Service