Applicant Record of Volunteer Service Section 1 - Volunteer InformationDate MM slash DD slash YYYY Name* First Last UF-ID* Gatorlink Email* Current Classification*FreshmanSophomoreJuniorSeniorGraduate Year 1Graduate Year 2Graduate Year 3Graduate Year 4Proposed Volunteer Supervisor Name* First Last Proposed Volunteer Supervisor Email* Have you ever pleaded "nolo contendere" (no contest) to or been found guilty (even if adjudication withheld) of a first degree misdemeanor or a felony?* Yes No If yes please list the date, offense and disposition (please explain fully):Are you volunteering for course credit?*YesNoIf yes, what is the course number? Have you volunteered in Neuroscience before?*YesNoDo you have a relative or roommate employed at UF? Yes No If yes, indicate names(s), department(s), and relationship(s).*Are you a student in the College of Medicine?*YesNoAre you a Foreign National?*YesNoAs a volunteer, I agree to abide by all applicable rules and regulations of the University of Florida and guidelines of this unit and to fulfill the volunteer responsibilities to the best of my ability. I understand that I will receive no monetary benefits in return for the volunteer service I provide and that the university may terminate this agreement at any time without prior notice. Signature*Required DocumentationDrivers License (or if foreign national upload Gator1 or passport)*Accepted file types: pdf, Max. file size: 125 MB.Foreign nationals: 1-94 front and back, EAD, 1-20 and/or DS2019Accepted file types: pdf, Max. file size: 125 MB.Screenshot of your My Training Transcript with current PBC810, PRV800 and PRV802 listed*Accepted file types: pdf, Max. file size: 125 MB.https://mytraining.hr.ufl.edu/ ; PCB810 General Compliance Training For College Of Medicine Personnel ; PRV800 HIPAA & Privacy - General Awareness ; PRV802 FERPA Basics. Please make sure the training dates are not expired.UntitledFirst ChoiceSecond ChoiceThird Choice
