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Community Partner Information Form
Community Partner Information Form
Information you submit in this form will be used to update our contact list of community organizations, refer faculty interested in teaching service-learning courses to relevant community organizations, and advertise volunteer opportunities to students. Thank you, and we look forward to supporting your work in our community!
Organization Information
Organization
*
Website
*
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Greenland
Grenada
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Sudan, South
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Yemen
Zambia
Zimbabwe
Country
Name
*
First
Last
Position Title
Phone
*
Email
*
Organization Details
Is your organization a nonprofit or government agency?
*
Yes
No
Type of Service Provided
*
Adult Education/Mentoring
Advocacy/Politics
Animal Welfare
Arts/Culture
Children/Youth Education/Mentoring
Crisis Support
Disaster Relief/Emergencies
Environment
Food Insecurity/Hunger Relief
Health/Medical
Housing/Homelessness
Immigrants/Refugees
International
LGBTQ+
Military/Veterans
People with Disabilities
Race/Ethnicity
Seniors/Elder Care
Sports/Recreation
Substance Abuse Prevention
Women/Girls
Other (Not Listed)
Are you interested in having UCA service-learning courses or student volunteers/interns work with your organization?
*
Interns
Ongoing Volunteers
Service-Learning Course
Volunteers for Specific Events
Current Opportunities
*
Please provide information about current opportunities for UCA students to get involved with your organization, including what, when, where, and how many students are needed.
Future Project Ideas
*
Please share any ideas you have for how students in particular disciplines could use their skills to assist your organization or the people you serve (including direct service or indirect, behind-the-scenes projects).
What departments/faculty/students do you think could best serve your organization?
*
Does your organization have specific guidelines or training for volunteers?
*
Yes
No
Are background checks required to work with your organization?
*
Yes
No
If background checks are required, by whom is the cost covered?
By Organization
By Volunteer
Are you interested in having UCA students host their own fundraisers or donation drives for your organization?
Fundraisers
Donation Drives
Please provide information about what types of donations your organization accepts (if applicable).
Has your organization worked with UCA faculty or students before? If so, briefly describe previous partnerships/projects and provide any feedback you would like to share.
*
Would you like to be added to the monthly Community Partner Newsletter?
*
Yes
No
Would you like to schedule a follow-up phone call with the Director of Experiential and Community-Engaged Learning?
*
Yes
No
Would you like to schedule a time for the Director of Experiential and Community-Engaged Learning to visit your organization?
*
Yes
No