Volunteer Request Form

Please be sure to read this before submitting: https://biology.unm.edu/assets/docs/admin/usage-volunteers-sop.pdf

Participant Name

Fist Name, Last Name

Participant Email Address

Under 18 Years of Age?

If you are under 18 years of age, your supervisor will need to complete a Background Check

Start Date for Volunteer

Requests for Volunteer Insurance Coverage cannot be guaranteed unless submitted at least three (3) business days prior to the planned volunteer activity

mm/dd/yyyy

End Date of Service

If known, please include the end of the volunteer project

Name of Person Volunteering Under

Faculty/Staff/Principal Investigator (PI) of Project

Email of Person Volunteering Under

Phone # of Person Volunteering Under

Phone

Name of Project, Program, or Research

Name of Emergency Contact

Phone Number for Emergency Contact

Phone

Health Insurance Company

Policy Number

Severe Allergies or Medical Conditions

Yes

Please upload signed informed consent

https://biology.unm.edu/assets/docs/admin/usage-volunteers-sop.pdf

Drop your files here

Index for Liability Insurance and Background Check

Please ask supervisor for index

I hereby acknowledge I have reviewed and provided consent

I, the undersigned Participant, desire to volunteer at the University of New Mexico, Department of Biology, Castetter Hall. In consideration

for being permitted to participate and volunteer in the Department of Biology, I hereby agree to and consent to this project.

Send me a copy of my responses

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