Science Volunteer Network

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1 Science Volunteer Network THE HUMAN ELEMENT The only ones of you who will be truly happy are those who have chosen to serve. Albert Einstein East Los Angeles Community College Science Volunteer Program Deanna Deacon SVN Volunteer Coordinator

2 LOS ANGELES COMMUNITY COLLEGE DISTRICT 770 Wilshire Boulevard, Los Angeles, CA (213) Science Volunteer Network Mission Statement: To promote student search for science based knowledge, clarity and the application of laboratory based practices. Promoting high standards in learning laboratory practice and education. To elevate student understanding in scientific laboratory protocol through educational volunteerism advocacy. To promote the professionalism that is an expected of future clinicians. We dedicate ourselves to the development of future health and science professionals through student volunteerism. We will grow from the experience by passing forward the knowledge and the spirit of service. Deanna Deacon 6/04/2013 Volunteer Coordinator

3 Science Student Volunteer Program Minimum Requirements Should have a sincere interest in the health care or science field. Must have received a minimum letter grade of B in the course work you wish to volunteer. Should be at least 18 years of age. Complete application including a permanent address with original signature. Be currently enrolled in East Los Angeles College pursuing a career in the health care or science field with a minimum cumulative GPA of 3.0 Must attach current unofficial transcripts to your application. Pass the interview process which consists of an application process, introductory interview with volunteer staff, and possibility of an interview with the course subject Professor. Attend general mandatory orientation and department specific training. Be able to complete the semester clinical laboratory volunteer program assignment. Review the semester class schedule for the subject you desire to volunteer. Understand that you are expected to be in your assigned laboratory in accordance to your assigned schedule. EAST LOS ANGELES COLLEGE LOS ANGELES CITY COLLEGE LOS ANGELES HARBOR COLLEGE LOS ANGELES MISSION COLLEGE LOS ANGELES PIERCE COLLEGE LOS ANGELES SOUTHWEST COLLEGE LOS ANGELES TRADE-TECHNICAL COLLEGE LOS ANGELES VALLEY COLLEGE WEST LOS ANGELES COLLEGE

4 The information contained in this form shall be used in connection with all volunteer activities for the Los Angeles Community College District. Full Name: Volunteer Applicant Information: Residence Street Address: City: State: Zip code: Home telephone: Business/Day telephone: Birthdate: CA. Driver s License No.: Social Security No.: Emergency contact: Address: Phone No.: Name of school past or presently attending: GPA: Graduation year: Degree(s) earned and /or in process: Previous Volunteer Experience: Academic Goal: Duties: Hobbies/sports/personal talents: Why do you wish to volunteer for SVN program? Type of volunteer assignment preferred? Choose two 1 st : 1 st Professor/section number: 2 nd : 2 nd Professor/section number: In your desired volunteer course, What grades did you receive when you passed the course? 1 st : 2 nd : Name of Professor that taught your course: 1 st : 2 nd : EAST LOS ANGELES COLLEGE LOS ANGELES CITY COLLEGE LOS ANGELES HARBOR COLLEGE LOS ANGELES MISSION COLLEGE LOS ANGELES PIERCE COLLEGE LOS ANGELES SOUTHWEST COLLEGE LOS ANGELES TRADE-TECHNICAL COLLEGE LOS ANGELES VALLEY COLLEGE WEST LOS ANGELES COLLEGE

5 Volunteer Title: Volunteer Assignment Description: (To be completed by district location) Department Location: Professor and lab days/hours: Contact Person/Supervisor: Ext. Job description, duties, responsibilities and activities: Dates Needed: From: To: Time required: Minimum hours per week: Training required: yes no By whom: Qualifications: Education: Special Skills: Experience: Other: Use of Automobile: License Plate No.: EAST LOS ANGELES COLLEGE LOS ANGELES CITY COLLEGE LOS ANGELES HARBOR COLLEGE LOS ANGELES MISSION COLLEGE LOS ANGELES PIERCE COLLEGE LOS ANGELES SOUTHWEST COLLEGE LOS ANGELES TRADE-TECHNICAL COLLEGE LOS ANGELES VALLEY COLLEGE WEST LOS ANGELES COLLEGE

6 No person may serve as a volunteer in the District if: (1) He/she has been convicted of or if he/she has charges pending which pertain to any sex offense, such as child molestation (as defined in Education Code section 87010), or controlled substance offense (as defined in Education Code section 87011). (2) He/she has been convicted of a crime and a College President or District Administrator determines: (i) the nature of the crime is too serious to serve as a volunteer; (ii) the crime was too recent; and/or (iii) the crime is inconsistent with obligations in performing assigned duties as a volunteer. (3) He/she has a health condition which would preclude him/her from satisfactorily performing essential duties of the position. (4) He/she makes a false statement or omits a statement as to material fact on the application form. Report of Convictions: If you have a record of convictions for offenses other than minor traffic citations, please give details in the space below. Also, list any arrests for which you are currently out on bail or out on your own recognizance, pending trial. If the answer is NONE, write it across the first line and sign your name at the end of this application. CONVICTIONS/ARRESTS PENDING TRIAL: Date, City & State of Arrest Charge or reason given by police for arrest Date and location of trial Explanation (optional) EAST LOS ANGELES COLLEGE LOS ANGELES CITY COLLEGE LOS ANGELES HARBOR COLLEGE LOS ANGELES MISSION COLLEGE LOS ANGELES PIERCE COLLEGE LOS ANGELES SOUTHWEST COLLEGE LOS ANGELES TRADE-TECHNICAL COLLEGE LOS ANGELES VALLEY COLLEGE WEST LOS ANGELES COLLEGE

7 Additional conditions for serving as a volunteer in the Los Angeles Community College District: (1) Volunteer applicant acknowledges and understands that he/she serves the District in an at will capacity. The District may terminate a volunteer s services for any reason at all, except for the exercising of free speech rights with respect to issues of public concern. (2) Volunteers are considered to be independent contractors and are employees of the District only for the purpose of entitlement to workers compensation benefits for injuries sustained while engaging in the performance of any services under the direction and control of the District. (3) With the exception of workers compensation, volunteers serve without any type of compensation or benefits granted to District employees. Volunteers shall not be entitled to defense and indemnity from the District. (4) Individuals serving in Associated Student Organization officer positions at the colleges are not considered to be volunteers under the District s volunteer policy and are not entitled to defense and indemnity from the District. (5) Volunteers are subject to Los Angeles Community College District Board Rule et seq. and Los Angeles Community College District Administrative Regulation PS-5. (Copy attached) I certify that the information I provided on this application form is true to the best of my knowledge and belief. I also accept the terms and conditions set forth by the District in connection with my volunteer service. Signature: Date: EAST LOS ANGELES COLLEGE LOS ANGELES CITY COLLEGE LOS ANGELES HARBOR COLLEGE LOS ANGELES MISSION COLLEGE LOS ANGELES PIERCE COLLEGE LOS ANGELES SOUTHWEST COLLEGE LOS ANGELES TRADE-TECHNICAL COLLEGE LOS ANGELES VALLEY COLLEGE WEST LOS ANGELES COLLEGE

8 EAST LOS ANGELES COMMUNITY COLLEGE DEPARTMENT OF LIFE SCIENCES LAB VOLUNTEER POSITION DESCRIPTION DESCRIPTION OF DEPARTMENT: PURPOSE OF VOLUNTEERS: SUPERVISION: TRAINING: REQUIREMENTS AND QUALIFICATION: HOURS/DESIRED VOLUNTEER COVERAGE: VOLUNTEERS CAN: The East Los Angeles Community College, Department of Life Science offers a unique combination of both academic (transfer) and occupational (vocational) courses to enable students to attain a high level of competence in the biological sciences and related allied healthcare fields. Many of these offerings are organized into functional Skills Certificate, Certificate of Achievement and Associate Degree programs. SVN Volunteers will assist the Instructors with various aspects of student instruction within the appropriate permitted scope of duties and responsibilities. Student volunteer may assist enrolled students in their laboratory course work, but may NOT substitute a staff member. The SVN volunteer will assist the instructor with enrolled students course work ONLY under direct supervision. Volunteer Students instruction will be LIMITED to those activities listed below, and will also be restricted and based on specific orientation and approval of the course instructor and/or SVN volunteer Program coordinators. Volunteers Orientation training. Volunteers Conduct, Ethic, and Professional training Prior completed course work in the assigned volunteer lab course with a minimum earned grade of B. College Student, enrolled in East Los Angeles College Minimum 18 years of age with a sincere desire to become a PA, NP, RN, MD or science related field. Minimum of 3.0 College GPA Must be able to volunteer a MINIMUM of assigned lab hours for one semester. Prior course work in the lecture and lab you desire to volunteer for with a minimum earned grade of B. The Department of Life Sciences SVN Volunteer Program is a volunteer opportunity with shifts available Monday thru Saturday, during scheduled lab section hours. The primary responsibility of the volunteer is to volunteer in the Department of Life Sciences under the supervision of the course instructor by assisting the student s laboratory course work: Volunteers will primarily: Assist in all areas of the course laboratory limited to the instructor s direction. Gather supplies for the daily course procedures limited to the instructor s direction. Assist with clerical work that only pertains to the laboratory course assigned. EAST LOS ANGELES COLLEGE LOS ANGELES CITY COLLEGE LOS ANGELES HARBOR COLLEGE LOS ANGELES MISSION COLLEGE LOS ANGELES PIERCE COLLEGE LOS ANGELES SOUTHWEST COLLEGE LOS ANGELES TRADE-TECHNICAL COLLEGE LOS ANGELES VALLEY COLLEGE WEST LOS ANGELES COLLEGE

9 VOLUNTEERS CAN: VOLUNTEERS CAN NOT: Always identify yourself to staff and students and always remember to be professional. Good work ethic and acceptable attendance Assist students to develop a better understanding of in class laboratory safety and course work. MUST WEAR PROPER SAFETY ATTIRE THAT IS REQUIRED BY THE SPECIFIC COURSE, AT ALL TIMES. Provides positive feedback on the student s progress and encourages the student s continued focus on academic excellence. You need not know every answer; but you MUST know how to get back to the student with a solution to their problem, through research and/or teamwork! Discuss grades earned by students. Only the instructors can discuss and assign grades. Handle or transport any chemical(s) or corrosive items Obtain signatures or witness documents Lift heavy objects Offer private tutoring for the assigned volunteer course. ASSIST IN ANY FASHION, MANOR, SCHEME WITH THE INTENT TO ASSIST A STUDENT(S) TO CHEAT, COPY, OR ALLOW UNPRIVLAGED INFORMATION TO BE KNOWN. THE VOLUNTEER WILL BE TERMINATED FROM THE PROGRAM AND BARRED FROM ANY FUTURE PARTICIPATION IN THE SCIENCE VOLUNTEER NETWORK PROGRAM. You will be reported to the Department Chair and Dean of the college. SIGNATURE: Department Chair: Date: Volunteer: Print name: Signature: Date: Student ID#: Volunteer Emergency Contact: Phone numbers: / EAST LOS ANGELES COLLEGE LOS ANGELES CITY COLLEGE LOS ANGELES HARBOR COLLEGE LOS ANGELES MISSION COLLEGE LOS ANGELES PIERCE COLLEGE LOS ANGELES SOUTHWEST COLLEGE LOS ANGELES TRADE-TECHNICAL COLLEGE LOS ANGELES VALLEY COLLEGE WEST LOS ANGELES COLLEGE

10 EAST LOS ANGELES COLLEGE LOS ANGELES CITY COLLEGE LOS ANGELES HARBOR COLLEGE LOS ANGELES MISSION COLLEGE LOS ANGELES PIERCE COLLEGE LOS ANGELES SOUTHWEST COLLEGE LOS ANGELES TRADE-TECHNICAL COLLEGE LOS ANGELES VALLEY COLLEGE WEST LOS ANGELES COLLEGE

California State University, Los Angeles TRIO Upward Bound & Upward Bound Math/Science

California State University, Los Angeles TRIO Upward Bound & Upward Bound Math/Science Application must be completed in black or blue ink only. STUDENT INFORMATION Name: Social Security # - - First Middle Last Address: Apt.# Phone: ( ) City: State: Zip Code: Date of Birth: Place of Birth: