Willow Clinic Volunteer Application2016

Eligibility: To apply, you must be a current UC Davis student and must be enrolled at UC Davis for the 2016-2017 school year.

Submission: Email your completed application to by 11:59 pm onApril 23rd.

Please save your application as a PDF with the following file name: LastName_FirstName_2016Application

Late applications will not be considered.

Requirements:

  • Attend 4 Saturday clinics per quarter
  • Attend 4 Saturday clinics during the summer
  • Attend mandatoryclinic meetings on Mondays from 7:10-8:30 pm
  • 5-10 hours of clinic activities per week

Vaccinations

  • Tuberculosis (TB) Test (PPD test): 2 TB tests – one within the last 3 months, another no older than a year

Suggestion – if you can't remember when you last had a TB test, get

theinjection and have it "read" then retest a week later

  • Rubella (German Measles): Proof of MR or MMR immunization or serology showing immunity to Rubella
  • Rubella (Measles): Two doses of Measles Vaccine (or MMR) in a lifetime
  • Chicken Pox (varicella): is REQUIRED for UCDMC. Vaccination (2 shots required – 4 weeks apart) or proof of immunity by serology test for chicken pox.

Note, there is no cost for registered UCD students with SHIP to receive varicella vaccinations at SHWC

  • Hepatitis B Series: is recommended for UCDMC internships

Willow Clinic Volunteer Application2016

Name: Click here to enter text. Email address:Click here to enter text.

Expected graduation date (quarter/year):Click here to enter text.

Major: Click here to enter text.

Have you applied to Willow before? ☐Yes ☐No

If so, when?

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Are you in good academic standing with the university?☐Yes ☐No

Are you currently a member of another student-run clinic? ☐Yes ☐No

Are you able to commit to at least an entire year of work? (Summer 2016-Spring 2017)? ☐Yes ☐No

  1. Why do you want to volunteer with the homeless population?

Suggested word count: 300

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  1. Describe a time you took initiative.

Suggested word count: 300

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  1. What are your other commitments? How can you balance these commitments with Willow Clinic?

Suggested word count: 300

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  1. What personal attributes or experiences do you have that will contribute to Willow Clinic’s goal?

Suggested word count: 300

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  1. Think of an experience you had as a member of a team. What helped you reach your goals, and what did not?

Suggested word count: 300

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  1. Describe a time you encountered a problem, and explain the process you went through to solve it.

Suggested word count: 300

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  1. Please list any languages you speak other than English:

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  1. Please note if you have experience or a particular interest in any of the following:

Photography/Media ☐Yes

Pharmacy☐Yes

Dentistry ☐Yes

Wellness activities (art, yoga, meditation, etc) ☐Yes

Educational presentations ☐Yes

Explain any boxes you checked: Click here to enter text.