Volunteer Faculty Registration Form
UMDNJ
University Libraries
Smith Library
Please complete this form. Fields with an
*
must be filled
Please provide contact information for the UMDNJ
sponsor or coordinator of your volunteer service.
Volunteer Name
:
*
Volunteer Address
:
Volunteer Phone
:
*
Volunteer E-mail
:
*
Last 4 Digits of SSN
:
*
Department
:
*
Length of Service
:
*
Start/Ending
Dates of Service
:
*
UMDNJ Faculty
Sponsor/Coordinator
:
*
UMDNJ Faculty Phone
:
*
UMDNJ Faculty E-mail
:
*
Describe Volunteer Faculty
Involvement in UMDNJ
Educational Program :
Contact Us
:
Roberta Bronson Fitzpatrick
973-972-5498(or 2-5498) (Voice)
973-972-7474 (Fax)
e-mail
fitzparb@umdnj.edu