This
AmeriCorps Application and Contract
Packet includes the following:
AmeriCorps Member Agreement (pp.
2- 7)
This agreement is to be
completed by the AmeriCorps Member with the University of Arizona Graduate
College.
Attachments:
Applicants should submit
the following completed and signed documents:
Current resume with
three (3) references and a current transcript
AmeriCorps Enrollment
Form (OMB 3045-0006 Expires 07/31/2010)
Photograph and Video
Release Form
Assumption of Risk
and Release Form (complete with agency)
UA Grievance Procedure
(sign and date)
UA Statement on
Drug Free Schools and Campuses (sign and date)
Fingerprinting/Background
Check Information (current card or fingerprint information if required)
Current certifications
for CPR, First Aid and/or Disaster Shelter Reception Training if available
Pay Schedule Work
Sheet
AmeriCorps
Sponsoring Organization Information and Agreement
(pp. 8-15)
This portion of form is
to be completed and signed by the AmeriCorps Member and the host agency
representatives (authorized signature and fiscal officer). A signed
copy should be returned to the Graduate College AmeriCorps “Bringing
Service Home” Coordinator, Graduate College, Administration Building
Rm. 322D, POB 2100066, Tucson, AZ 85721-0066 for signatures by the Graduate
College. The agency should also have on file at the Graduate College
a current Agency Application Form. All forms may be downloaded
at http://grad.arizona.edu/peacecorp
under “For Agencies - Forms.”
I. AmeriCorps
Member with the GRADUATE COLLEGE AGREEMENT
ELIGIBILITY
Eligibility
for an AmeriCorps Member position is based on the following qualifications.
As an
AmeriCorps Member I certify through this agreement that
I am:
A U.S. citizen,
U.S. national or lawful permanent resident alien of the United States.
At least 17 years
of age at the beginning of service.
Willing to provide
either 900 hours of service for a half-time position or 450 hours of
service for a quarter-time position. In either position, no more than
20% of the hours may be expended in professional development or training
in order to complete the term of service and be eligible for the AmeriCorps
education award. No more than 10% of total hours may be for fund raising
activities.
Eligible to obtain
a Fingerprint Clearance Card from the State of Arizona and/or to pass
a background check appropriate to positions working with at-risk populations.
If a student, in
good academic standing, maintaining at least a 3.00 grade point average
(major and cumulative) prior to and during the term of service.
Willing to provide
direct services and/or strengthen the community or build the capacity
of the organization.
An AmeriCorps
member who is also a Peace Corps Fellows/USA
certifies that he/she:
1. Has completed
two full years of Peace Corps service; or completed two full years of
service minus 90 days if returned home on emergency leave; or been granted
an “Early Close of Service" or "Interrupted Service"
due to circumstances beyond personal control; or if medically separated has completed
a year of service including training.
2. Has been admitted as
a graduate master’s, doctoral or specialist degree seeking student
in a Peace Corps Fellows/USA (to be referred to as a “Fellows program”)
approved department.
RESPONSIBILITIES
The
AmeriCorps member agrees to:
Discuss with your
supervisor possible work site risks and dangers associated with the
position, then complete and sign the Assumption of Risk Release Form
and submit it to the UA
AmeriCorps
coordinator.
2. Represent the University
of Arizona as an ambassador to the community and abide by the Student
Code of Conduct, the Code of Academic Integrity, and the Drug Free Workplace
regulations of The University of Arizona.
3. Follow the policies,
procedures, rules, and regulations of the University of Arizona and
the sponsoring organization/host site.
4. Perform duties for the
hours and duration agreed upon. It is the Member’s responsibility
to
arrange any planned absences with the host site supervisor.
5. Ensure that your supervisor
is able and willing to submit an evaluation on your behalf. Some organizations
have personnel policies prohibiting your supervisor from providing a
written intern evaluation. If this is the case, special arrangements
must be made for your supervisor to speak directly with the Fellows
coordinator about your performance. The Member is expected to distribute
evaluation surveys to the supervisor.
6. Complete all reporting
requirements for the position as specified by the AmeriCorps Program.
At the beginning and end of service, the Member will participate in
an interview with the program coordinator. Each quarter and at the end
of the semester, the Member will complete and submit an evaluation form
to the program coordinator in a timely fashion. The Member will submit
service hours completed through online biweekly timesheets through the
Graduate College. AmeriCorps service hours are reported to the Corporation
for National Service to qualify the member for an educational award.
7. AmeriCorps Members
are required to:
Present a current
fingerprint card or undergo a criminal background check and fingerprinting
as part of the screening process or to provide evidence of current screenings/certifications
in effect if working with an at-risk population.
Complete the required
service hours established for the AmeriCorps position.
Observe the specific
federal and state regulations and policies that govern the AmeriCorps
grant.
Provide evidence
of certification in CPR, First Aid, and Disaster Shelter Reception training
or if not already certified complete such training during the term of
service. Members are expected to participate in other professional development
provided through the Graduate College Peace Corps Fellows Program, the
student’s department or the AmeriCorps host agency up to, but not
exceeding 20% of total hours. Members may take Human Subjects, safety
or other training required by the host agency as appropriate (safety
training, HOV training et al).
Participate in two
or more service project per academic year with the Bringing Service
Home Program selected from AIDS/Walk Tucson (Oct. 18), Community Food
Bank Marana Farms Project (Nov. 1), National Homeless Count (Jan.09),
Peace Corps Week Fair, Humane Borders Migrant Trash Pickup. Service
is also encouraged on National Days of Service.
Members are strongly
encouraged to participate in State AmeriCorps sponsored events including
Regional Forum, Legislative Day and the Governor’s Conference on Volunteerism.
AmeriCorps members
are prohibited from some activities while in the course of their duties
as AmeriCorps Members. Members may not engage in activities prohibited
by the Corporation for National & Community Service regulations
in 45 C.F.R 2520.30, including: illegal activities; activities
that pose a significant safety risk to others; attempts to influence
legislation or an election or aid a partisan political organization;
helping or hindering of union activity; engaging in religious instruction;
conducting worship services; providing instruction as part of a program
that includes mandatory religious instruction or worship; or constructing
or operating facilities devoted to religious instruction or worship.
The Grievance Procedures
of the University of Arizona are available to AmeriCorps members to
resolve disputes concerning suspension, dismissal, or evaluation. These
procedures are attached.
Members who require
accommodation for a disability may register with the UA Disability Resource
Center and may make request for accommodation.
RESPONSIBILITIES OF THE GRADUATE COLLEGE
The Graduate College
AmeriCorps Bringing Service Home Program:
Selects and enrolls
eligible applicants who satisfy the AmeriCorps member requirements.
Informs Members
of AmeriCorps program and UA workplace policies and procedures.
Documents communication
with the Member and host agency supervisor regarding AmeriCorps activities.
Contracts with the
AmeriCorps Member and disburses the AmeriCorps living allowance. The
Graduate College is not responsible for any financial obligations incurred
by the Member for his/her service participation including, but not limited
to, travel, housing arrangements, health, dental, and vision care benefits,
child care benefits or agency background checks.
Through the agreement
with the University of Arizona, workman’s compensation is available
for medical care for injuries resulting from the student’s AmeriCorps
service experience.
Notifies the Member
of the kind and amount of living allowance and Segal Education Award
available to the Member.
Provides timesheet
and evaluation forms for the Member and the host agency supervisor.
Conducts an orientation,
training, and periodic professional development activities.
Conducts an entrance
and exit interview.
Benefits
Part time AmeriCorps members
will receive a taxable living allowance of $5820.00 through The University
of Arizona Graduate College. Quarter-time members will receive a taxable
living allowance of $2910. Income taxes, FICA and Workman’s Compensation
will be deducted directly from the living allowance. The living allowance
will be distributed biweekly in accordance with the University of Arizona
payment schedule attached. The living allowance is based on the total
hours of service and is prorated over the selected term of payment.
No health, vision, dental or childcare benefits are available to Members
through this program. Members must select a pay schedule from the following
options and submit a living allowance worksheet with the enrollment
package.
HALF TIME
MEMBERS900
hours
LIVING
ALLOWANCE PAY OPTIONS
$5,820.00
LA units
gross pay per pay period
total living allowance
3
months, 6 pay periods
970.00
9.7000
$
970.00
5,820
5
months, 10 pay periods
582.00
5.8200
$
582.00
5,820
6
months, 12 pay periods
485.00
4.8500
$
485.00
5,820
7.5
months, 15 pay periods
388.00
3.8800
$
388.00
5,820
10
months, 20 pay periods
291.00
2.9100
$
291.00
5,820
QUARTER
TIME MEMBER450
hours
LIVING
ALLOWANCE PAY OPTIONS
$2,910.00
LA units
gross pay per pay period
total living allowance
3
months, 6 pay periods
485.00
4.8500
$
485.00
2,910
5
months, 10 pay periods
291.00
2.9100
$
291.00
2,910
7.5
months, 15 pay periods
194.00
1.9400
$
194.00
2,910
At the satisfactory
completion of service, a
Segal
Educational Award credit will be
disbursed
by the National Corporation for Public Service.
The Education Award for one year of
h
alf-
time service is $2,362.50. The award for a 450 hour Quarter-time
membership is $1,250.
The educational benefits are provided from the National Service Trust
of the United States Treasury. The payment will be made to the
academic institution, program, or l
oan holder designated by the Member. The educational award
is to be used solely for educational expenses.
A Member
’
s
failure to disclose to the Program any history of having been released
for cause from another AmeriCorps Program will render the Member i
neligible to receive the education award.
Members may serve a total of two years of AmeriCorps service and
qualify to receive the living stipend and educational award for two
years only.
Terms of Service
The
Year III
AmeriCorps membership term of service
may commence on or after
10/01
/2008
and
concludes on or before 09/30/2009
.
If allowed
by the grantee
, the term of service may be extended. Members will be notified in
August 2009 of any
such extension.
T
he Member
must serve
a total of
450 (Quarter-Time) or
900
(Part-Time)
hours
during the period of the grant according to the
agreed upon
schedule
.
The
M
ember
may extend the term of service if
he or she
has been suspended due to compelling
personal circumstances or service has been terminated, but reinstated
through a grievance procedure.
Renewal of this agreement for
a second
term
of AmeriCorps service is dependent on satisfactorily completing responsibilities
herein.
Members may receive
full benefits for two terms of AmeriCorps service.
This agreement may be changed
or revised by written consent of both parties.
Authorization
The Member and Program hereby
acknowledge by their signatures that they have read, understand, and
agree to al
l terms and conditions of this agreement.
C
omplete the following
by
print
ing your
name, sign
ing
,
dating and return to program Coordinator.
________________________________________
___________________
AmeriCorps Member
Name and
Signature
Date S
igned
_________________________________
_______
___________________
Georgia Ehlers
,
AmeriCorps Program
Coordinator
Date Signed
_________________________________
_______
___________________
Dorian Voorhees, Assistant
Dean
Graduate College
Date Signed
Attachments
PHOTOGRAPH AND VIDEO RELEASE FORM
I grant permission to The Arizona
Board of Regents, on behalf of the University of Arizona and its agents
or employees, to use photographs taken of me on the date and at the
location
listed below for use in university publications such as recruiting
brochures, newsletters, and magazines, and to use the photographs on
display boards, and to use such photographs in electronic versions of
the same publications or on University web sites o
r other electronic form or media, and to offer them for use or distribution
in other non-university publications, electronic or otherwise, without
notifying me.
I hereby waive any right to
inspect or approve the finished photographs or printed or electron
ic matter that may be used in conjunction with them now or in the
future, whether that use is known to me or unknown, and I waive any
right to royalties or other compensation arising from or related to
the use of the photograph.
I hereby agree to release,
defend, and hold harmless the Arizona Board of Regents, on behalf
of The University of Arizona and its agents or employees, including
any firm publishing and/or distributing the finished product in whole
or in part, whether on paper or via electronic medi
a, from and against any claims, damages or liability arising from
or related to the use of the photographs, including but not limited
to any misuse, distortion, blurring, alteration, optical illusion or
use in composite form, either intentionally or otherw
ise, that may occur or be produced in taking, processing, reduction
or production of the finished product, its publication or distribution.
I am 18 years of age or older
and I am competent to contract in my own name. I have read this release
before signing
below, and I fully understand the contents, meaning and impact of
this release. I understand that I am free to address any specific questions
regarding this release by submitting those questions in writing prior
to signing, and I agree that my failure to
do so will be interpreted as a free and knowledgeable acceptance
of the terms of this release.
Location of Photo/Video
Date
Name (please print)
Signature
Signature of guardian if under
18 years of age
II. SPONSORING ORGANIZATION INFORMATION AND AGREEMENT
Background Information
The University of Arizona (UA)
Graduate College
, through the Arizona Board of Regents,
is a State AmeriCorps subgrantee
for a
n AmeriCorps State
program known as
Bringing Service Home
. Through
this program
, we
ar
e placing
28 quarter-time and 6 part
-time in
AmeriCorps Members
at host sites as a means of
meeting community needs in education and literacy, the environment,
public health and community and economic development
.
The
initial AmeriCorps
grant was awarded O
ctober 1, 2006 and
has been renewed
two additional years.
The Year III AmeriCorps award is for the period from October 1, 2008
–
September 30, 2009. A possible 3-month no-cost extension may be
awarded in August 2009.
AmeriCorps
Members
commit to a term of service
at a host site
that meets
one or more of
the goals of the program
. AmeriCorps is a stream of service
funded by
the Corporation for National & Community Service
through
the Governor
’
s Commission on Service and
Volunteerism (the prime grantee)
.
The goals of
Bringing Service Home
are to meet critical needs of the state
and local communities in southern Arizona in environment, health and
nutrition,
education,
literacy, emergency preparedness, forest health and fir
e mitigation, youth development
, and human needs
.
Financial Provisions
AmeriCorps
Members are not considered volunteers, staff, workers, participants
or employees. Members receive a
living allowance
for their service
from the UA Graduate College
.
The li
ving allowance
is taxable and a W-2 form is provided to the Member
by the UA
. The living stipend is paid as a pro-rated amount over the period
of service directly from the Graduate College. Half-time
M
embers receive a total of
$5820.00
and q
uarter-time Mem
bers receive a living stipend of $
2910
.00
.
Members will cease to receive the living allowance when they conclude
their hours of service.
At the successful conclusion
of service, Members
also
receive an educational
award
through
the Corporation for Nationa
l & Community Service
from the U.S. Treasury National Service Trust
. The award is directed
to a
school,
college or university of the Member
’
s choice
for tuition, fees, loans or other educational expenses
, and
may be used over a seven-year period
.
A Part-t
ime Member receives an
educational award
of
$2362.50 and a
quarter-time
Member receives an
educational
award is
$1250.00.
Host agencies provide financial
cost sharing
for the project by a contribution of
5
% of the student
’
s living stipend
and 100% of fri
nge benefits
.
The agency cost share will be billed by the UA Graduate College
Fiscal
Office in two invoices, one half-way through service and the final
invoice at the conclusion of service. Should a Member not complete service,
the amount billed to the age
ncy will be prorated based on the disbursement of the living allowance
to the Member.
Cost-share funds provided by the host agency may not be from federal
or sub-federal sources.
The
cost share
rate
schedule
for 2008-09 Year III
is as follows:
Host agency match for
AmeriCorps year 3
Agency Cost Share
Agency Cost Share
Living Allowance
100% Fringe Benefits
5% of Living Allowance
Total Match*
UA student
half time
5,820.00
192.06
291.00
483.06
quarter
time
2,910.00
96.03
145.50
241.53
Non student
half time
5,820.00
582.00
291.00
873.00
quarter
time
2,910.00
291.00
145.50
436.50
* amount subject to change due to FY ERE
rates
*UA ERE (benefits)
rates are revised each spring effective July 1. This schedule is based
on rates for FY2008-09. Agencies will be notified of any changes
effective July 1, 2009.
University of Arizona Graduate
College Responsibilities
The Graduate College assumes
responsibility for the following:
Manages the AmeriCorps member
application process, including assistance with recruitment, interview,
receipt of enrollment forms, and final selection of AmeriCorps member.
Enrolls the Member with the Corporation
and National Trust and processes forms to place the Member on the AmeriCorps
payroll at the UA Graduate College.
Distributes the living allowance and
deducts and processes payments for FICA and Workman’s Compensation
through the University of Arizona .
Provides a W-2 at the conclusion
of the tax year.
Invoices the host agency for the agreed
upon rate at the mid-point and end of service.
Tracks and reports hours of service and other
required reporting to the grantee in cooperation with the host agency.
Administers subgrantee funds for the
Member living stipend, training, travel to AmeriCorps required events,
and provides AmeriCorps apparel for the Member.
Provide Members with an orientation
to the AmeriCorps Bringing Service Home program, as well as mentors
Members throughout the service period.
Provides regular opportunities for
professional development, training, social and service activities to
strengthen skills pursuant to academic and professional objectives.
Provides a UA liaison for host sites,
with periodic opportunities for agency training and planning, evaluation,
and site support for monitoring and reporting of activities.
Facilitates use
of the UA Grievance Procedure
if a dispute arises with the Member.
Prepares and submits quarterly,
annual reports and closeout reports to the grantee.
Sponsoring
Host Site Responsibilities
The sponsoring/host site organization
assumes responsibility for the following:
Assigns a full-time professional
as the Member Supervisor and a contact person for the Graduate College
program coordinator.
Provides appropriate space and equipment,
including access to a phone and computer, to perform the tasks required.
Provides a
Service Position
Description
outlining the Member’s expected service at the host agency
containing the following elements. This Service Position Description
becomes a part of this agreement. The Member service position description,
should include the following:
a)
Title and Purpose of the Position
- Describe the general purpose of the position and describe the beneficiaries
of the services to be provided.
b) Status of
the Member – Describe the Member’s status within the agency,
including start and end date, expected schedule of hours to accomplish
the required service hours, and any additional benefits offered. The
schedule should allow for flexibility for exam schedules of students,
holidays, other permitted absences, and professional development and
training required by the Member.
c) Minimum Qualifications
- Describe the minimum qualifications required of the position.
Minimum qualifications should include education, work experience, personal
qualities, and special skills and knowledge.
d) Service
Description – Broadly describe the functions required including
duties and responsibilities, and identify the specific office and supervisory
structure at the host site. Include the name and position title of the
Member’s supervisor and billing contact.
e) Specific Guidelines
and Requirements for Members – Provide a detailed list of what
is expected from the intern and a definition of the organization’s
obligations to the intern. The former may include items such as the
intern’s specific job functions and/or the intern’s professional
responsibilities with regard to the organization’s policies for office
conduct, etc. The latter may include items such as conditions of continued
employment, potential for full-time employment after graduation, mentoring
by full-time professionals in the organization, formal communication
lines between the supervisor and intern, etc.
Provides the
Member with pertinent orientation, training, and informs the Member
of policies and procedures of the host agency necessary for success.
5.Provides or permits relevant
education and training for the Member.
Supervises and
evaluates the Member’s performance following each academic semester
on an electronic survey that will be forwarded to the agency by the
Member at the end of each semester.
Maintains the
AmeriCorps Member status of the position, to be distinct from agency
employment status. The host agency may not supplant or replace employees
with AmeriCorps Members.
Notifies the
UA Bringing Service Home AmeriCorps coordinator of significant issues
requiring intervention or leading to a decision to remove the Member
from an service position prior to the agreed upon time. Problems such
as failure to comply with rules and regulations or failure to carry
out the assigned responsibilities should be reported to the Coordinator.
If the agency elects to terminate the Member, the agency is asked to
provide a written report to the UA Coordinator stating the reasons for
termination.
Completes and
submits end of semester and/or a Final Evaluation form at the end of
the Member’s service.
10. Permits and assists
the Member in reporting output efforts and outcomes of the Member at
the
Host agency for quarterly reports to the granting agency.
Restricts total
hours spent by the Member on fundraising to no more than 10% of all
service hours and permits up to 20% of hours to be used for professional
development and training, including participation in UA Bringing Service
Home trainings and events for Members.
Allows participation
in at least two service projects per year and Peace Corps Week. Agencies
are invited to participate in Peace Corps Fair on the last Wednesday
of February.
Remits the cost
share from non-federal or sub-nonfederal sources within 30 days upon
receipt of invoice.
SAMPLE
SERVICE AGREEMENT DESCRIPTION
The following form
may be used for the AmeriCorps service agreement, or the agency may
utilize its own form which should contain the following information.
To use this form,
insert cursor in gray box and type.
Member Name
AGENCY
CONTACT INFORMATION
Sponsoring/Host Organization:
Division/Department:
Agency Telephone # Fax
#
Agency Director: Title
Director’s Phone # Director’s
E-mail
Member’s Supervisor:
Supervisor’s Title:
Supervisor’s Phone #
Supervisor’s E-mail
Fiscal Officer Contact for Billing
Phone Email
Billing Address
OVERVIEW OF
POSITION
Please summarize or describe the responsibilities
of the position, including goals, desired outcomes, audiences that will
benefit, and how the project fits into the overall agency organization:
FUNCTIONS OF POSITION
Identify the primary physical location
of Member’s service activities:
On-site Activities/Responsibilities:
List all basic duties, functions and essential tasks that must be performed
with or without reasonable accommodations.
Identify marginal duties that are preferred:
Identify internal and external working
relationships required for successful accomplishment of responsibilities.
MINIMUM QUALIFICATIONS
Educational or Academic Background:
Experience Required:
Specialized Skills/Knowledge/Abilities
including the degree to which these physical emotional and/or intellectual
demands are required of the position:
Physical Demands/Work Environment:
Tools/Equipment/Machinery to be used:
Other Information Necessary to Successful
Execution of the Position:
MEMBER
AGREEMENT
Expected Start Date:
Expected End Date (by which all hours
are completed):
Proposed Weekly Schedule (days of week,
general hours):
Average Total Hours of Service Per Week
Expected:
Planned Supervisor/Member Contact Hours
per week:
Please note if the Member will receive
any of the following:
☐
Professional Development/Training Benefits
☐
Travel Assistance/Reimbursement
☐
Room & Board
Other Compensation
If the student will be transported or
driving a vehicle owned by the agency, the agency verifies that:
☐
Agency provides adequate automobile
liability insurance that would cover the students in the event of an
accident;
☐
Drivers have appropriate driver's licenses,
trainingand good driving records
☐
Vehicles are in good operating condition.
☐
Note if the agency provides:
☐
Fingerprint clearance
☐
Background check
☐
CPR Certification
☐
First Aid Certification
MEMBER’S LEARNING OBJECTIVES
(The Member is asked to describe his or her own learning objectives
for the experience. This section is to be completed by Member in connection
with agency discussion.
1. Objective
Percentage of Time:
2. Objective
Percentage of Time:
3. Objective
Percentage of Time:
CONDITIONS OF AGREEMENT
The UA Graduate College and
the Sponsoring/Host Organization, in finalizing this agreement, shall
make no distinctions or discriminate against any applicant for the service
position on the basis of sex, race, creed, national origin, age, or
handicap.
In consideration of the opportunity
to participate in this service, the undersigned Student and Sponsoring/Host
Organization do for themselves, their heirs, administrators and assigns,
hereby release, discharge, and indemnify The University of Arizona,
the Graduate College, and the Corporation for National and Community
Service, its representatives, administrators, employees, and students
from any and all liabilities, losses, damages, claims, fines, suits
or actions of any kind and nature, resulting from or arising out of
any actions, omissions, or negligence of the performance of this agreement.
Furthermore, the Sponsoring/Host Organization will provide the AmeriCorps
Member with safety procedures and information as is customarily provided
regular employees of the Sponsoring/Host Organization.
INFORMED LIABILITY STATEMENT
I understand that The University
of Arizona and its representatives have arranged to establish an AmeriCorps
position with the Sponsoring/Host Organization, which complies with
academic, and employment regulations, policies, and procedures of The
University of Arizona.
The daily managerial control
and working conditions of the Member are under the sole discretion of
the Sponsoring/Host Organization and its designated agents. Consequently,
the Host Organization understands that The University of Arizona, the
Graduate College, and the Corporation for National and Community Service,
its deans, directors, administrators, and employees, do not assume and
cannot assume any liabilities, losses, or damages to me or others resulting
from or connection with acts, judgments, omissions, or negligence occurring
during my work for and with the direction of the Sponsoring/Host Organization
or its agents. In consideration of this, I have been informed of the
importance of securing employer benefits or making my own arrangements
for personal and professional liability.
This agreement can be terminated
at any time by mutual consent of the Sponsoring/Host Organization, the
AmeriCorps program coordinator, and the Member. The AmeriCorps member
agrees to notify the Sponsoring/Host Organization and the AmeriCorps
program coordinator two weeks prior to the end of the internship.
I have read and understand
the terms of this document.
____________________________________________________________________
AmeriCorps Member Signature
Date Signed
____________________________________________________________________
Sponsoring Organization Authorized
Signature Date Signed
____________________________________________________________________
Authorized Fiscal Officer for
the Host AgencyDate Signed
____________________________________________________________________
Georgia Ehlers, Bringing Service
Home CoordinatorDate Signed
___________________________________________________________________
Dorian Voorhees, Assistant
Dean Graduate CollegeDate Signed
The
University of Arizona
Bringing Service Home
AmeriCorps
Year III Member Agreement
of
15
University of Arizona
AmeriCorps Member Agreement
rev. 09/30/08