Skip to Content

Member Forms

Member/Site Development

Mentor-Member Agreement
Mentor-Member Monthly Meeting
Placement Site Orientation Checklist
WSP Mission Exemption Form
Monthly Safety Log
WSP Request for Member Assistance

Member Preliminary Site Visit Questionnaire

Watershed Assessment Evaluation

Member Bio Template

Timesheets

Absence and Additional Time Worked Report (STD 634)

Reimbursement Forms

Travel Expense Claim (TEC) 2010 Form

Reference/Samples

Travel and Subsistence Operations Manual

SAMPLE Livescan

Required TEC fields

Individual Service Project Forms and Supplemental Materials

Pre-Project Planning

ISP Proposal Form

Sample Volunteer Recruitment Campaign

Donation Letter Template

Information to Provide for Volunteers at ISP

ISP Introduction Script Template

Adult Volunteer Sign-Up Form

Youth Volunteer Sign-Up Form

Creek Geeks Brochures

Volunteer Survey

Media and Publicity Tools

Sample Media Campaign
Central Region Media List
Northern Region Media List
Southern Region Media List

Link to "Northern Region Publicity Boards" Map

Post Project

ISP Summary Form

ISP Debriefing Questions

Media Templates

Public Service Announcement

Sample Flier: Wetland Weed Wallop

Sample Flier: HFAC Collaboration

Sample Flier: MRC Native Grass Planting

Education Forms

Pre-Post Test Templates:

Pre-Post Test A (K-2nd)

Pre-Post Test B_C_D (3rd-5th/6th-8th/9th-12th)

Pre-Post Test Answer Keys:

Pre-Post Test A (Answer Key)

Pre-Post Tests _B_C_D (Answer Key)

Blank Forms:

Pre-Post Test Tally

Pre-Post Test Tally Sample

Pre-Post Test Tally Tips

Teacher Contract

Teacher Perception Survey

Outreach Forms

Outreach Log
Request for Outreach Participation
Outreach Event Evaluation

Evaluation Forms

Member Evaluation
Placement Site Evaluation

WSP Program Evaluation

Member Skills Development Survey

Worker's Compensation Forms

For You

CCC 38 Report of Minor Injury Form (call the Member Coordinator to fill this out)
CCC 50 Witness Statement Form (have any witnessness fill this out)

SCIF 3301 Worker's Comp Claim Form (only fill out fields 1-8)

SCIF 3301 Acknowledgement Form

For Your Doctor

Y16 AmeriCorps Member Job Analysis (bring this each time you see the doctor for a WC claim)

CCC 272 Doctor's Evaluation of Injury/Illness Form

For Your Reference

Have you suffered a work related injury?

Guide to Worker's Compensation for New State Employees

SCIF Contact List

Grievance and Appeals Forms

CCC 2-2 Corpsmember Grievance Form

Letterhead Templates

2010 WSP Letterhead

LOGOS

Theme by Dr. Radut.