SHORELINE COMMUNITY COLLEGE

OFFICE OF HUMAN RESOURCES & EMPLOYEE RELATIONS               Spring  2006

16101 Greenwood Avenue N, Shoreline WA 98133

(206) 546-4769

 

 

VOLUNTEER WORKER REGISTRATION FORM

 

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Last Name                                First Name                                M.I.                                       Birth date

 

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Street Address                                                              City                              State                 Zip      

 

(________)_______________________(__________)______________________________________________________

Home Telephone                                   Work Telephone                                                            E-Mail

 

Auto License Plate Number (for parking permit) ______________________________

 

Start Date________________      End Date__________________   Budget Number  145-111-1T03

 

Describe the tasks and activities to be performed (include student you tutor or teacher you work with, room number, level, and schedule-time and days- if you have an assignment):

 

_________________________________________________________________________________________________

 

_________________________________________________________________________________________________

 

_________________________________________________________________________________________________

 

_________________________________________________________________________________________________

 

 

I understand that as a volunteer of Shoreline Community College, I must complete and submit a time sheet for any month in which I perform volunteer work.

 

 

______________________________________________                 ____________________________

Signature of Volunteer (in ink)                                                                      Date

 

 

Recommendation of Volunteer:

 

The individual named above is recommended for acceptance and registration as a volunteer worker for Shoreline Community College, in accordance with and for the limited purpose of medical aid benefits under RCW 51.12.035. 

 

Subject to approval by the College’s Director of Personnel, I agree to submit signed time sheets for this volunteer’s hours worked.

 

Recommended By (print)   Betsy Binnian                                                            Phone ext. 546-6959

 

                        Signature____________________________________                  Department Essential Skills

 

Comments: ______________________________________________________________________________________

 

________________________________________________________________________________________________

 

________________________________________________________________________________________________

                                                            [     ] Accepted             [     ] Denied

 

Human Resources Signature_______________________________________       Date____________________________