K-12 Classroom Request Form
Thank you for requesting a volunteer placement. Once you are contacted by your K-12 school, you may start volunteering. Please check your Spam regularly, as sometimes the school district's emails go to Spam. Email Pre-Professional Coordinator Katie Blackwell if you have any questions, and enjoy your classroom experience!
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Email *
Volunteer Expectations & Agreement *
Read the Pre-Professional Volunteer Expectations. In order to receive a classroom placement, you must electronically agree below. 
Your first and last name as it appears on GOLD *
If you prefer a name that is different from GOLD, please include it in parenthesis: Guillermo (Memo) Martinez
UCSB Perm Number
 *
You must currently be enrolled in UCSB in order to volunteer through the Pre-Professional Program.
Cell Number *
805-567-8910
Which course(s) are you enrolled in? Check all that apply. *
If you are not enrolled in an ED course you may still volunteer, as long as you are over the age of 18 and are currently enrolled at UCSB. You can track your hours using the Fieldwork Verification form. If placements are impacted, priority will go to students who are enrolled in an ED course. 
Required
If you are not taking an ED course, approximately how many hours would you like to volunteer each week? 
Leave this question blank if you are enrolled in an ED course. 
Grade Level & Subject Request - First Choice  *
  • ED 128 students must choose elementary. 
  • ED 130 students must choose secondary math. 
  • ED 131 students must choose your preferred secondary science. 
  • ED 121 & 122 students should choose the level and subject that you think you might want to teach someday. 
Grade Level & Subject Request - Second Choice
If your first choice is not available, what is your second choice? 
  • ED 128 students must choose elementary. 
  • ED 130 students must choose secondary math. 
  • ED 131 students must choose your 2nd choice secondary science. 
  • ED 121 & 122 students should choose their 2nd choice level/subject that you think you might want to teach someday. 
Clear selection
Volunteer Availability: When will you be available to volunteer between 8:00am-3:30pm on M/Tu/W/Th/F during the quarter you're taking the course? Try to list at least six hours of availability, including at least one morning. 

Most schools have lunch between 12:00-1:00(ish). If your only availability is during that window of time, we will not be able to place you. 

Write your availability like this example: 
M 8-10, Tu/Th 1-3, F 8-3:30
 *
Do you have a location preference? 
Please note that we have limited availability at all of our K-12 schools, and we might not be able to accommodate your preference. 
Do you have a car? *
Are there any specific K-12 schools or teachers you would like to request? (optional)
If you request a specific teacher, please also provide their school name. Again, please note that we might not be able to accommodate your request. 
If you have volunteered in previous quarters, at which school(s) were you placed? (check all) *
Required
If you are taking ED 122 for the second time, which teacher, grade, and school were you with the first time you took ED 122? 
Additional Comments (optional): If there is any extra information you wish to convey about your placement preferences, please do so briefly here.  
When you press submit below, I will start working on your classroom placement. If you drop your ED course or change your mind about volunteering, please email me immediately so that I can let the school know you will not be volunteering.  *
A copy of your responses will be emailed to the address you provided.
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