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PASADENA AREA COMMUNITY COLLEGE DISTRICT
Office of Human Resources
Request for Volunteer Assignment
TO BE COMPLETED BY VOLUNTEER
Name (please print)
Social Security #
Address
City State Zip
(______) ___________________________ ________________ Male_____ Female_____
Area Code Phone Number Date of Birth
NOTE: Individuals cannot volunteer for the same services for which they have previously received compensation.
Are you currently working or volunteering in another department or division? Yes ___ No___
Please indicate where: _________________________________________________________________________________
Signature Date
TO BE COMPLETED BY DEPARTMENT
Supervisor _________________________________ Ext. _________ Department _________________________________
(Please Print)
CONDITION FOR VOLUNTEERS
• Must pass livescan background
/ /
mm dd yy
Requested Start Date
• Duration of assignment not to exceed current fiscal year
• Serves without compensation EMP#:__________________
• Must not perform work typically performed by a regular employee
Please provide a brief description of the work to be performed:
PLEASE NOTE: New volunteers
CANNOT start volunteering until the manager receives an email approval indicating the
effective start date from Human Resources.
Requested by ______________________________________ ___________________________________________
Cost Center Manager’s Name (please print) Signature
TO BE COMPLETED BY HUMAN RESOURCES
__________________________________________ ___________________ ________________________
Assistant Director, Human Resources Signature Date Authorized Start Date
Form Request Volunteer Assignment Revised March 2019
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