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Fax: 831-459-5599

Volunteer Agreement: Letter

• Volunteer Guidelines
• Volunteer Agreement: Letter
• Volunteer Agreement: Election of Workers' Comp Coverage
• Volunteer Monthly Roster
  

VOLUNTEER AGREEMENT: LETTER

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TO: Physical and Biological Sciences Docents and Volunteers
FROM: David S. Kliger, Dean of Physical and Biological Sciences

The Division of Physical and Biological Sciences utilizes docents and volunteers to further enhance the vital link between the UCSC campus and the Santa Cruz Community. We rely on individuals, such as yourself, to enhance our programmatic efforts. I want to thank you for your participation which ensures the continuity of our programs and helps us to continue to meet the challenges within the academic community.

Staff volunteers must complete this form and the Election of Workers’ Compensation Coverage form (see reverse) and return the completed forms to their department supervisor prior to performing any volunteer activity. In the event that an accident or injury occurs while providing volunteer services, immediately report to the supervisor and complete the required Workers’ Compensation Claim forms within 24 hours of the injury. In the event of an injury which requires medical care, volunteers are authorized to seek medical care as follows:

• Weekdays 8:30 am to 4:30 pm: Cowell Student Health Center
• After normal work hours, and weekends:
  Dominican Hospital Emergency Room
  1555, Soquel Dr.
  Santa Cruz, CA
• Emergencies - Call 911

Please sign and date the lower portion of this form and the Election of Workers’ Compensation Coverage indicating that you have read and understand your responsibilities as a volunteer. As a member of the campus community, you are expected to comply with all policies, procedures and health and safety regulations that the campus enforces. At the discretion of the University, the services of a volunteer may be terminated at any time. Again, your contribution is sincerely appreciated.

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Volunteer’s Name (please print)_________________________________________________

Address____________________________________________________________________
      street   city   state   zip code

Home Phone Number(___)_____________Daytime Phone Number (___)______________

Volunteer appointment begins ____________________and ends_____________________
                      (mo/day/yr)  cannot be blank or indefinite (MO/day/yr)

In the event of an emergency, notify (include name, phone number and relationship): ________________________________________________________________________

Volunteer’s Signature _______________________________________Date____________

Supervisor’s Name__________________________Dept.____________Extension_______

Supervisor’s Signature_______________________________________Date____________

Note to supervisors: Please return original volunteer letter and the Election of Workers’ Compensation Coverage to the Physical and Biological Sciences Business Office. Retain copies of both for your file, and provide the volunteer with a copy of each as well.

ALSO COMPLETE THE Volunteer Agreement: Election of Workers' Comp Coverage