UHEAN Exit Unlock Request

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Hello UHEAN Member,

Please complete this form when you are ready to begin exiting your term of service. Once you and your Campus Coordinator have completed the required forms, we will start your final audit. Your patience is appreciated.

If you have questions about how to answer this form, please contact your Campus Coordinator.

Remember, once we have unlocked your forms, you only have 30 days to complete your exit in order to receive your award!

Email *

Member First and Last Name *

Program Grant Year * *

Program *

Priority Status *

Normal

Exiting Early (You may not re-enroll for 60 days after you have been exited)

Re-enrolling

Need for Financial Aid

Close to 12 month term

Graduating

Have you audited all monthly forms for completeness and correctness? See the how to page for explanations: https://www.uhean.org/completing-monthly-forms *

Yes

What Term of Service have you completed? *

300

450

675

In which focus area did you serve? *

Healthy Futures (nursing, social work, dental hygiene, etc.)

Education 1 (tutors, student teachers)

Education 2 (college access and success advisors, mentors)

Capacity Building (service centers on campuses or other non-profit organizations)

What was the most difficult part of completing the Volunteer Mobilization Project? *

If someone asked me to describe AmeriCorps, I could easily answer their questions. *

Strongly Disagree

Strongly Agree

The support provided to me by my campus coordinator was sufficient for me to successfully complete my term of service. *

Strongly Disagree

Strongly Agree

The training and support provided to me by my site supervisor for my service site was sufficient for me to successfully complete my term of service. *

Strongly Disagree

Strongly Agree

The training and support provided to me by UHEAN staff was sufficient for me to successfully complete my term of service. (Includes orientation, monthly newsletters, Facebook Group, etc.) *

Strongly Disagree

Strongly Agree

I utilized the UHEAN.ORG website: (Check all that apply) *

During the Enrollment Process

While I was serving in my term (for videos on how to do monthly reports, etc).

During the Exit Process

Required

For which of the following will you use your Education Award? (Check all that apply) *

Begin study at a university/college

Earn a certificate

Pay off student loans

Continue study on an associate's, bachelor's, or master's degree

Complete my degree

Required

Will you participate in AmeriCorps again in the future? *

Yes

N/A I have maxed out my 4 Terms of Service with UHEAN

Would you recommend this AmeriCorps Fellowship to others? *

Do you have any other comments, suggestions, or concerns? *

Would you like to nominate your Campus Coordinator for CC of the Year and leave a shout out or thank you? *

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