UMN Program Submission Form: Submission #819

Submission information

Submission Number: 819

Submission ID: 4101

Submission UUID: de1ac181-756b-4242-a605-5d4932130121

Submission URI: /program-submission-form

Created: Thu, 06/01/2023 - 23:46

Completed: Thu, 06/01/2023 - 23:46

Changed: Thu, 06/01/2023 - 23:46

Remote IP address: 172.69.59.111

Submitted by: Anonymous

Language: English

Is draft: No

Webform: UMN Program Submission Form

Submitted to: UMN Program Submission Form

Please indicate which type of program you would like to submit: K-12 Youth Event/Program/Camp/Intern/Conference (In-Person and/or On line)

Basic Information

Program Title Lab volunteer

Unit Department of Psychiatry and Behavioral Sciences

Link to Program Registration NA

Description A high school student from Wayzata High School is going to volunteer in RADLab this summer.

Phone (612) 625-3403

Email (point of contact for participants) [email protected]

Program Director/Leader Kathryn R. Cullen

Program Leader Email [email protected]

Program Information

Start Date Thu, 06/01/2023 - 00:00

End Date Fri, 09/01/2023 - 00:00

Months Offered Jun, Jul, Aug

Age 17

Estimated number of participants 1

Subject Science, Technology, Engineering, and Math

Program Location Twin Cities/Central MN- Virtual

Publish on Youth Central website? No

Staffing Information

Have all covered staff/volunteers passed a background check within the last three years? Yes

Have all covered staff/volunteers completed the Safety of Minors mandatory training via the Training Hub? Yes

Will there be a minimum of two program staff on duty at all times who are 18 or older and two years older than the oldest participant? Yes

Will all program staff/volunteers/student workers receive an orientation? Yes

Safety of Minors Information

Have you planned appropriate physical environments to ensure quality learning environments and help prevent illnesses and accidents? Not applicable

Is there a plan to change facilities or modify activities for participants with special needs? Not applicable

Is there a plan to change facilities or modify activities in case of extreme weather? Not applicable

Have you assessed the environment to determine if minors need to be accompanied to the bathrooms? Not applicable

Is there a plan for the safe movement of minors? Not applicable

Do minors attend without a parent or other caretaker? No

Does the program lodge people overnight? No

Has the program operated previously? Yes

Were any incidents of suspected abuse known to have been reported to or by staff in the last year? No

Notification Date Thu, 06/01/2023 - 00:00

Will a minor be present in lab environment? {Empty}

Virtual Program Information

Is this a virtual program? Yes

Is the platform supported by the University of MN? Yes

Will you be live streaming your program? No

Have all staff/volunteers completed virtual safety guidelines training? Yes

Has oversight been established to include a minimum of two adults during all virtual engagement activities? Yes

Is recording taking place? No

I agree to the terms of service. Yes