ࡱ> 9<8/ 8bjbj 8*|bh|bh8`````tttt$tn$ "V`---``(MMM-"``M-MMM1qO.M>0$#$#$#<qn----$#X &: THE UNIVERSITY OF MAINE AT AUGUSTA Application for UMA Volunteer Program: In-state Undergraduate Students Only URGENT: The UMA Volunteer Tuition Waiver Program is a financial resource which student must report to the Financial Aid Office. The receipt of this waiver may affect your eligibility for other aid programs. Applicant is REQUIRED to contact Jamie Santiago, Director of UMA Financial Aid, before submitting this application. Once the Director has signed the form, it will be forwarded to the Volunteer Program Coordinator. Applicant cannot begin volunteer hours until the form has been signed by the Director of Financial Aid. You can reach Director Santiago at 207/621-3244 or by E-Mail at Jamie.santiago@maine.edu. If you have a resume, please attach it to this application. PERSONAL INFORMATION Name: ______________________________________________ Daytime Phone: _____________________ First Middle Last Current Address: __________________________________________________________________________ Street City State Zip How many hours a week would you be available to volunteer? ________ What schedule would you prefer? _____________________________________________________________ List three (3) volunteer activities that interest you the most in order of preference. Include any relevant experience and your qualifications: 1. _______________________________________________________________________________________ _______________________________________________________________________________________ 2. _______________________________________________________________________________________ _______________________________________________________________________________________ 3. _______________________________________________________________________________________ _______________________________________________________________________________________ At which UMA location would you like to volunteer?________________________________________________ Are you currently employed, including work-study? If so, where and in what capacity? ___________________________________________________________________________________________ May we contact your employer for a reference? Yes____ No____ If not employed, please provide names, addresses and phone numbers of three (3) references: 1. _______________________________________________________________________________________ 2. _______________________________________________________________________________________ 3. _______________________________________________________________________________________ I understand that if I am selected to participate with the UMA Volunteer Program that this program is considered a financial resource. I also understand that if I am a recipient of any financial aid, including but not limited to grants, scholarships, work-study, tuition waivers, and/or student loans to attend college that I must immediately report the receipt of any Volunteer Waiver(s) to the Financial Aid Office. Volunteer Signature___________________________________________________________________ Date___________________ Supervisor Print & Signature____________________________________________________________ Date__________________ FA Director Jamie Santiago Signature_____________________________________________________Date__________________ Volunteer Coordinator Signature________________________________________________________ Date__________________ Return with a job description and resume (if applicable) attached to: Lynn I. Poor, Volunteer Program Coordinator UMA Lewiston Center 51 Westminster St, Ste 162 Lewiston, ME 04240-3536 Phone: (207) 753-6605 E-Mail: umavolunteer@maine.edu In complying with the letter and spirit of applicable laws and in pursuing its own goals of pluralism, the 鶹APP shall not discriminate on the grounds of race, color, religion, sex, sexual orientation, national origin or citizenship status, age, handicap, or veterans status in employment, education, and all other areas of the University. Questions and complaints about discrimination in any area of the University should be directed to the Director of Equal Opportunity, 鶹APP, Farmhouse, Augusta, Maine 04330, (207) 621-3110. Inquiries about discrimination may also be referred to the Director, Office of Civil Rights, U.S. Department of Education, Region I, John W. McCormack Post Office and Courthouse Building, Boston, MA 02109. Revised 5/26/2022 LIPoor #Qwxy I K X ` ! 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