Bhagat Puran Singh Health Initiative University of California, Davis• www.bpshi.com • California State University, Sacramento Bhagat Puran Singh lived a life devoted to serving others. While he was homeless, he begged for money not to nourish himself, but those who were even less fortunate than he. Starting with nothing, Puran Singh cared for an abandoned child diagnosed with leprosy. Eventually, he was able to build the largest free health care institution in India, called Pingalwara (Home for the Handicapped and Abandoned). In honor of Bhagat Puran Singh’s devotion to humanity and selfless service, UC Davis and Sacramento State students collaborated to start the Bhagat Puran Singh Health Initiative. Where Bhagat Puran Singh dedicated his life to serve those in need, we hope to make a mark on the world by striving to live as he did by using our knowledge, manpower, and resources. Our mission: 1. To provide basic health care screening and general health/nutrition advice to undeserved and neglected communities. 2. To fight heart disease and diabetes among the at-risk populations and promote general health knowledge to prevent chronic disease. 3. To Promote Youth Advancement among underserved populations. 4. To Promote Social Justice among our members and in the community. Another integral aspect of BPSHI are the special projects and outreach, which are organized by means of committee work. The following includes explanation of what each committee entails: Social Justice Committee: Work with groups such as Ensaaf, Jakara, SEVA: Selfless Service, Saanjh etc. to promote community advancement and advocate equity for all communities with emphasis on underserved/neglected communities, domestically and internationally Coordinate the Farmer Suicide Program, Bone Marrow Registry, Feed/Clothe the Homeless, etc. Improve the social justice awareness of all BPSHI members of the pertinent issues affecting our communities today. (i.e. Health Care Reform) EMR/Public Health Committee: Will be integrating our patient medical records on Electronic Medical Record Will work closely with Public Health Graduate Student to direct BPSHI programs towards increasing health care accessibility and cultural sensitivity to underserved communities Initiating projects, working closely with our targeted population, keeping track of data, performing clinical research Health Education/Nutrition Committee Will work closely with volunteer Physicians, Public Health Graduate Students, and Medical School students to gear Health Education towards different communities Maintain interactive portfolio to educate youth and adult populations on various health risks associated with various target communities and suggested lifestyle changes Organize children’s health presentations Fundraising Committee Will plan and coordinate with other organizations (ie: bhangra competitions, melas, campus events) in order to incorporate BPSHI fundraisers at the events Organize fundraisers Work on grants Will organize sale of wristbands and T-shirts at BPSHI events Bhagat Puran Singh Health Initiative Member Application 20122013 Application Instructions: Email the application to: Please, Subject Your Email as: ucdavis@bpshi.com First_Last_BPSHI BPSHI Member Expectations: Attendance at BPSHI meetings once a month will be mandatory, these will be held every first Thursday of every month at 7:00pm (excluding finals weeks or holidays) Mandatory attendance at one clinic per month Committee involvement *if you have a conflicting commitment that impedes your ability to follow the BPSHI member expectations please include them in the body of your email. Please fill out the following, carefully and honestly. If you have any questions, comments, or concerns please email us at: ucdavis@bpshi.com I. Name (First Last): II. Email Address: III. Phone Number: IV. Birthday (mm/dd/yyyy): V. Emergency Contact (and phone number): Age: School: Major/Minor: VI. Pre – (Underline/Highlight one): Medical Dental Other: ____________ Pharmacy Optometry Law VII. Year in School: VII. Please Highlight/Underline your level of Punjabi fluency: None IX. Some Graduation Date: Moderate Proficient Fluent List all other languages spoken: X. Have you been trained by BPSHI before? ____ Yes ____ No I, _______________, promise to uphold the integrity of the Bhagat Puran Singh Health Initiative at their events by acting in a professional manner and agree to maintain the confidentiality of all medical records in accordance to HIPAA regulations. In addition, I give BPSHI the permission to use my photographs on their websites, brochures and other documents. QUESTIONS: Please respond to each question below in a complete, concise, and honest manner. (Word Count: 150-300 words per question) 1) Why do you want to be a part of BPSHI? 2) What are your future aspirations? How can you benefit from BPSHI? 3) Describe any skill set/special qualities you can contribute to this organization. How will you use these skill sets/special qualities to move BPSHI forward? 4) Please look at our Projects Tab on the website for current projects (http://bpshi.com/uc-daviscsus/projects/). Please tell us about which of these projects interests you and why. Please also use this space as an opportunity to tell us about any projects you would like to start up. THANK YOU FOR SHOWING INTEREST IN THE BHAGAT PURAN SINGH HEALTH INITIATIVE!