First Name:     Last Name:

You are:
Parent
Community Member
Student (please indicate your program. ex: MSW, MPH, junior-biology)

Email:

Which component of PHS are you interested in volunteering for:
Weekly Teaching (Sept-Dec)
Weekly Teaching (Jan-Apr)
One Time Events (this will put you on our email list if you are not already on it)

How did you hear about PHS?
Ginsberg Center
School Orientation
From a friend
Other (please describe):

ONLY ANSWER THE QUESTIONS BELOW IF YOU ARE INTERESTED IN WEEKLY TEACHING

Which days can you volunteer? Mark all options but you will only be assigned to one day.

Can you teach:
In Ann Arbor from 11:37-12:02? Yes     No
In Ypsilanti for an hour in the morning? Yes     No
In Ypsilanti for an hour in the afternoon? Yes     No

Do you have your own method of transportation? Yes     No

Do you want to teach with a partner?
No, I am fine teaching solo
Yes, please pair me up
Either way is fine
Yes – and my partner's name is:

Please let us know any comments or questions that you might have.