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UNIVERSITY OF WISCONSIN – LA CROSSE_ SOS VOLUNTEER APPLICATION

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					   UNIVERSITY OF WISCONSIN – LA CROSSE, SOS VOLUNTEER APPLICATION

NAME:__________________________________________________                           Date of Birth:_________________________
               Last                       First                  Middle Initial

LOCAL                                                                             LOCAL
ADDRESS:_____________________________________________                             PHONE:_____________________________

______________________________________________________  PREFERRED MODE TO BE CONTACTED:
                                                        PHONE:_____________________________
PERMANENT                                               E-MAIL:_____________________________
ADDRESS:____________________________________________________________________________________

WHICH NIGHTS OF THE WEEK CAN YOU VOLUNTEER FOR THE SOS PROGRAM?
      SUNDAY     MONDAY   TUESDAY    WEDNESDAY    THURSDAY   FRIDAY                                         SATURDAY

CURRENT YEAR IN SCHOOL:                 FR        SO        JR           SR       (circle one)

HOW DID YOU HEAR ABOUT SOS?  POSTERS     CLASS    INVOLVEMENT FEST     AN ORGANIZATION
      E-MAIL FRIEND     OTHER:________________________________________________________

ARE YOU VOLUNTEERING BECAUSE OF AN OUTSIDE COMMITMENT (CLUB, CLASS, ETC.)?                                          YES      NO

If yes, please explain:____________________________________________________________________________

HAVE YOU EVER BEEN ARRESTED OR CONVICTED OF A FELONY?                                  YES          NO

If yes, please explain:____________________________________________________________________________


PLEASE LIST THE NAME/ NUMBER OF A REFERENCE (RA/PROFESSOR/SUPERVISOR/HALL DIRECTOR).

Name: ____________________________________________ Phone: __________________________________


PLEASE EXPLAIN WHY YOU ARE INTERESTED IN BEING A UW-L SOS VOLUNTEER.
(Please attach an additional sheet if necessary.)

_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________


To the best of my knowledge, the above information is accurate and complete. I authorize the SOS Program to contact any of my
previous employers or references. I also authorize Protective Services to check my personal record for any previous arrests or
convictions. I also authorize SOS to publish my first name, last name, and picture on an SOS website and in other publications for
recognition and publicity purposes only.

Signature:_________________________________________________ Date:______________________________


PLEASE ASK YOUR REFERENCE TO COMPLETE AND SUBMIT THE ATTACHED FORM.
PLEASE RETURN COMPLETED APPLICATION TO THE OFFICE OF STUDENT LIFE, 149 GRAFF
MAIN HALL.

The University of Wisconsin - La Crosse is committed to providing equal education and employment opportunity
regardless of race, sex, gender identity or expression, religion, color, creed, disability, sexual orientation, national
origin, ancestry or age.
(8/06)
                       University of Wisconsin – La Crosse
                        SOS Volunteer Recommendation
 PLEASE HAVE YOUR REFERENCE FILL OUT THE FOLLOWING FORM IN DETAIL. THANK YOU.



NAME OF SOS APPLICANT: ____________________________________________________________

YOUR NAME:________________________________________________________________________

HOW DO YOU KNOW THE APPLICANT? _________________________________________________

____________________________________________________________________________________

HOW LONG HAVE YOU KNOWN THE APPLICANT? ________________________________________

THE APPLICANT IS APPLYING FOR A POSITION WITH THE UW-L SOS PROGRAM, WHICH PROVIDES A SAFE WALK TO
ANY STUDENT ON CAMPUS BETWEEN THE HOURS OF 8:30 P.M. AND 12:00 A.M. SOS APPLICANTS/VOLUNTEERS NEED
TO BE RELIABLE, TRUSTWORTHY, PROFESSIONAL, AND SAFETY CONSCIOUS. WHAT DO YOU KNOW ABOUT THIS
APPLICANT THAT DISPLAYS THESE QUALITIES?




WOULD YOU RECOMMEND THIS APPLICANT FOR THE UW-L SOS PROGRAM?                     YES  NO
ADDITIONAL COMMENTS:




SIGNATURE:                                                ________ DATE:__________________

PHONE NUMBER:___________________________________________

E-MAIL:____________________________________________________

PLEASE RETURN THIS FORM TO THE APPLICANT OR THE OFFICE OF STUDENT LIFE:

       OFFICE OF STUDENT LIFE
       149 GRAFF MAIN HALL
       LA CROSSE, WI 54601

                  IF YOU HAVE ANY QUESTIONS, PLEASE FEEL FREE TO CALL
                       THE OFFICE OF STUDENT LIFE AT (608) 785-8062.
                               THANK YOU FOR YOUR TIME!
Community Service

        Students may volunteer for SOS and use the volunteer hours to meet community service
requirements under the following circumstances:
       Community service is a requirement for a UW-L course
       Community service is a requirement for a UW-L student organization or club
       Community service is a requirement for a La Crosse organization or club
       Community service required as a result of legal action will be approved at the discretion of the
        SOS Advisor in the Office of Student Life. Because SOS provides safe walks to UW-L students,
        faculty, and staff, it is important to make sure our volunteers will not present a possible threat to
        our clients.


Alcohol and Drug Use
        SOS volunteers will not consume any alcohol or illegal drug during their shift. Any volunteer
thought to be under the influence of alcohol or an illegal substance will not be allowed to work that shift.
If a second offense occurs, the volunteer will be removed from the volunteer list. The coordinators
working the night of any incident will report the events to the SOS Advisor, who will determine if further
action will be taken.




 The University of Wisconsin - La Crosse is committed to providing equal education and
 employment opportunity regardless of race, sex, gender identity or expression, religion,
color, creed, disability, sexual orientation, national origin, ancestry or age of an individual
                                         or individuals.
                          Volunteer Information Survey
                         (This information may be used on the SOS webpage)



Hometown?


What is your Major/Minor?


What is one of your favorite movie quotes?


If you could have any super power what would it be?


RANDOM FACT ABOUT YOURSELF:
                  EXPECTATIONS OF UW - LA CROSSE S.O.S. VOLUNTEERS




 Report to the Cartwright station with a UW-L I.D. by 8:30.m. from Sunday – Saturday. You will be
  met by the S.O.S. Coordinator on duty. S.O.S. is in operation from 8:30 p.m. to 12:00 a.m. nightly.

 When providing a safe walk, two people (1 male and 1 female OR 2 females) are always expected to
  walk the caller, and one person is expected to answer any incoming calls or be available at the table.
  Always carry the walkie-talkie.

 Volunteers will not be allowed to go to the room of the person being walked for any reason. Take
  people from front door to front door only. Make specific arrangements on the phone about which door
  you will meet the caller. (Example: Front door of Laux Hall).

 Always wear an S.O.S. jacket or shirt while out on a safe walk.

 All volunteers must have an application on file in order to perform safe walks. Unauthorized people,
  i.e., friends, relatives, etc., may NOT accompany S.O.S. Volunteers on safe walks for any reason.

 There will be no sexual connotations associated with a safe walk. You may not ask the person you
  are escorting for a date or ask them for any personal information while on the safe walk.

 An S.O.S. Volunteer shall not drink any alcohol on the night he/she is on duty. Any S.O.S. Volunteer
  with alcohol on his/her breath will be immediately dismissed.

 No outgoing calls allowed on the S.O.S. cell phone.

 Volunteer at least 2 nights/month. Please sign up with an S.O.S. Coordinator, e-mail
  sos@uwlax.edu, or call the Office of Student Life (785-8062) to schedule shifts.

 Act in a manner that positively reflects the interest of the S.O.S. Program on and off duty.

 If you are unable to meet your obligation as a volunteer on any given night, please call the S.O.S.
  number (785-8787) and leave a message at least 24 hours in advance of any changes, cancellations,
  or switches.

 As an S.O.S. Volunteer, if you fail to follow these expectations, you will no longer be allowed to
  volunteer for the S.O.S. Program.




                           If you have any concerns or questions please contact:

                        Sara Johnson, SOS Program Graduate Adviser – 785-8065
                                                  OR
                       Safety on Our Sidewalks (SOS) Volunteer Policies
                    Marcia Johnson-Sage, Student Services Coordinator –
                    785-8066

				
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