Shands Arts in Medicine » UF Health » University of Florida

Name*

First Last

Phone*

Email*

Department/Major*

Expected Career Path*

Are you over the age of 18?*

Yes
No

Are you volunteering for class credit?*

Yes
No

If yes, please indicate

Course Title	# of hours to be completed by end of term

If yes, please indicate

Course Title	# of hours to be completed by end of term

Please select your FIRST choice for placement from the drop down menu*

If your selection is a Music discipline, please indicate the days/times in which you are available for a 30min-1hour shift

Please select your SECOND choice for placement from the drop down menu*

If your selection is a Music discipline, please indicate the days/times in which you are available for a 30min-1hour shift

Please select your THIRD choice for placement from the drop down menu*

If your selection is a Music discipline, please indicate the days/times in which you are available for a 30min-1hour shift

Please briefly describe your expectations for your volunteer experience with us.*

Describe your experience, background and skill level in the arts discipline in which you are applying*

Anything else you would like us to know? (e.g. Are you in the Center for Arts in Medicine certificate program? Do you have a strong preference to work with pediatric patients, are you bilingual?, etc.)

New AIM Volunteer Information Form