Seattle University Youth Initiative K-12 Service Application
Tell us about yourself!
7-digit SU ID #:
Emergency Contact Name:
Emergency Contact Phone:
If selected Other, please specify:
Racial/Ethnic Background (Check all that apply):
If selected Other, please specify:
Please select your SU affiliation:
If Undergraduate Student, Major:
Anticipated year of graduation:
Are you an International Student?
Are you currently in a Service Learning class?
If yes, please write the last name of your service learning professor:
Tell us about your service history!
Returning Volunteers, how many quarters have you participated in our K-12 partner schools?
Have you participated in other CSCE/SUYI programs? (Check all that apply)
Please select the TOTAL number of quarters participated from your selections above (If you have not participated in above programs, select 0 )
Program preference at your placement site:
Teacher preference (if applicable):
Schedule: Please indicate the times you are available to volunteer at your placement site.
Please read carefully. Checking the "I agree" box indicates that you agree to the following:
SERVICE EXPECTATIONS: I understand the service expectations presented by the Seattle University's Center for Service and Community Engagement (CSCE) and agree to the following:
- Attend a service orientation session prior to being placed in a school and attend service reflection sessions or related workshops and trainings during your volunteer/service learning commitment. Dates and times are announced via email.
- Comply with all policies of the placement site.
- Provide a minimum of two hours per week for at least one academic quarter at your placement site.
- Contact the CSCE staff 296-2569 and report any problems or difficulties that may arise during your service experience
BACKGROUND CHECK: Seattle University obtains or asks others on its behalf to obtain, consumer reports and/or investigative consumer reports, including Background Checks for criminal convictions and civil findings related to violence, abuse, and/or neglect against minors or vulnerable adults, from a consumer reporting agency regarding applicants who will be working with minors. These reports assist us in evaluating individuals for volunteer and service learner placement with Seattle University's Center for Service and Community Engagement partner schools and organizations.
- I understand that this service placement requires me to complete an online Background Check. (Background checks are only required once every academic year).
- I understand that I will receive an email with an online link and instructions for applying for my Background Check from TalentWise.
- I understand that my service placement is considered "pending" until the results of my online Background check have been made available to the Center for Service and Community Engagement.
- If I fail to complete the Background Check application within 48 hours of receiving email instructions, I understand that my registration with this service site may be dropped.
- I understand that I have an ongoing obligation to report any future criminal convictions or civil adjudications to the Center for Service and Community Engagement while I am participating in service.
- I understand that this Background Check does not take the place of any application processes that my service site requires.
- I understand and agree that Seattle University's Center for Service and Community Engagement will receive the results of the background check and can provide a copy of the results to the service site, if the site requests a copy. Finally, I understand and agree that the Center for Service and Community Engagement has the sole discretion to determine my suitability for participation in any aspect of the program, including my suitability to serve, with or without regard to the results of my background check.
RISK RELEASE: I understand that in connection with my participation in a Center for Service and Community Engagement and Seattle University Youth Initiative sponsored programs. and/or my service, if I suffer any injury (including death), illness, loss, or damage, I agree not to sue and will release and forever discharge Seattle University and its governing board, officers, faculty, employees, and students from any and all claims, demands, causes of action, costs, or expenses that can or may arise from my participation in Center for Service and Community Engagement and/or Seattle University Youth Initiative sponsored programs and partner organizations. This release and covenant not to sue is binding on my family, my heirs, and anyone else who claims an interest through me or from me.
I certify that the information given in the Service Application is true and complete to the best of my knowledge. I agree to inform the CSCE staff promptly if any of the information I provided changes during the time I participate in Seattle University 's Center for Service and Community Engagement activities.
Checking the "I agree" box indicates that you agree to the previous statements