Please complete this application form if you are interested in becoming a volunteer tutor or intern at The Preuss School UCSD. Once you complete the form, click the submit button at the bottom.

Name and address

First name:

Last name:

Street 1:

Street 2:

City:

State:

* Zip: *

Home phone:

OK to call me here

Cell phone:

OK to call me here

Email address:

Demographic Information

You may optionally provide the following information. It is used only to help us get a better idea of the demographic make-up of our volunteers.

Date of birth:

Gender:

Language other than English?:

Foreign Language Spoken:

Email Preferences

We like to keep volunteers informed of important news, schedules, and volunteer opportunities by email, however will not send you any email you prefer not to receive. Use the check-boxes below to select the kinds of email you would like to receive from us.

What kinds of email would you like to receive?

Electronic newsletters
School Administrators and teachers contribute to The Preuss School Newsletter to provide information on current and past events, helpful tips and tools, changes in school policies, and state/nationwide changes in testing and/or school curriculum.

Recruitment appeals
When ongoing or when one time volunteer opportunities are available you receive information with details about the school needs.

Monthly Events
A list of the current monthly events including dates and times for field trips, drama or music performances, testing schedules, school closures, PTA meetings, and sports schedules.

Important Information/Notices
Receive important information from the Volunteer Coordinator. Reminder for school closure/breaks/holidays, or school/block schedule changes. This box should be checked by every volunteer.

Rerfered by

Please let us know if you are serving as a volunteer for any program and how you heard about our volunteer opportunities.

Serving as a Volunteer for::

Referred by:

Check if volunteer hours are required:

Availability

We are on a block schedule and each class is 1 1/2 hours long. Tutors are expected to volunteer Mondays & Wednesdays or Tuesdays & Thursdays. Fridays are optional. Intern hours are flexible.

Monday-Thursday school hours are 8:00am-4:00pm.

Fridays school hours are 10:15am-4:00pm.

After school tutoring is from 4:00pm-5:20pm Monday-Friday.

Saturday Enrichment Academy is 9:00am-11:00am twice a month.

Note: There are different opportunities for volunteering. Select which type of volunteer opportunity you would like to be assigned to. If this opportunity is not available tutoring will be offered to you.

Type:

Educational Background

Education:

Major degree:

Minor degree:

Graduation Date:

College/University Name:

Experience

Please share any previous experience you have working with children grades 6th-12th. Include experience in tutoring a subject(s), scouts, church, or other information to help us place you in the appropriate volunteer role at Preuss.

REQUIRED

Current Employment or Volunteer Experience

Please complete this section with your most current experience. If you are not working or only have volunteer experience please list your previous employer or volunteer experience.

Please also answer this question: Have you ever been dismissed from a volunteer or work position?

REQUIRED

UC Path Question

Are you currently or have you ever been employed by UC San Diego (as staff, student employee, faculty, etc.)?

If you are currently employed or have been employed by UC San Diego in the past, please enter your UC Path/Employee ID.

REQUIRED

Personal References

1

2

First name:

Last name:

Middle name:

Street 1:

City:

State:

Zip:

Home phone:

Cell phone:

Relationship:

Emergency Contact

First name:

Last name:

Title:

Home phone:

Cell phone:

Relationship:

Volunteer Code of Conduct

1. Immediately upon arrival, I will sign in at the main office or designated sign-in station.

2. I will wear or show volunteer ID whenever required by the school to do so.

3. I will use only adult bathroom facilities.

4. I agree to never be alone with individual students who are not under supervision of teachers or school authorities.

5. I will not contact students outside of school hours without permission from the students' parents.

6. I agree NOT to exchange telephone numbers, addresses, email, or any other home directory information with student for any purpose unless it is required as part of my role as a volunteer. I will exchange home directory information ONLY with parental and administrative approval. If you would like to send a note to a class, please email the teacher so that s/he may share the email with the class. Please do NOT contact students directly. For example, contacting students through Facebook or other social media websites is STRICTLY PROHIBITED.

7. I will maintain confidentiality outside of school and will share with teachers and/or school administrators any concerns that I may have related to student welfare and/or safety.

8. I agree to NOT transport students without the written permission of parents or guardians or without the expressed permission of the school or district and will abide by district administrative procedure #4586 when transporting students.

9. I will not disclose, use, or disseminate student photographs or personal information about students, self, or others.

10. I agree only to do what is in the best personal and educational interest of every child with whom I come into contact with.

I declare under penalty of perjury, that all the information on this application is true and correct. I also declare that I have read and agreed to follow the "Volunteer Code of Conduct".

I Agree