Name:
Mailing Address:
City: State: ZIP:
Home Phone: Cell Phone:
Email Address:
Current employee at Cuesta? Yes (if yes, what department _______________________ No
Current student at Cuesta?
Yes
No
If you checked “No” to the above two questions, please fill out the following information for a parking permit:
Vehicle License: Vehicle Make/Model:
Vehicle Color: Vehicle Year: Driver’s License #:
VOLUNTEER WORK REQUEST 2020-2021
Definition of a volunteer: “Someone acting without legal obligation; a participant in something who is not legally bound
to participate and does not expect to be paid.”
Directions: Volunteers complete Part I. Fingerprint clearance and TB work clearance is required of all volunteers.
Human Resources will provide paperwork. Board Policies are available here.
No volunteer may begin college volunteer activities until this form is completed and approval has been given by the
Human Resources Office.
PART I
COMPLETED BY VOLUNTEER
PART III COMPLETED BY HUMAN RESOURCES
Legal Name: Banner ID:
Fingerprints TB Test Social Security Card Driver’s License Employment Data Form
The volunteer named on this form has completed and submitted all of the required paperwork.
Human Resources Signature: Date:
PART IV COMPLETED BY PUBLIC SAFETY
Volunteer parking permits may be issued to volunteers of the college. Approval is required by Public Safety.
Department:
Time Period Valid Through:
Permit #
NO CHARGE
Public Safety Approval: Date:
PART II
COMPLETED BY REQUESTING DEPARTMENT
Requesting Department:
Volunteer services to assist with:
Earliest Preferred Start Date: End Date:
Supervisor (Print name):
Date:
Supervisor Signature:
Approving Manager (Print name):
Date:
Approving Manager’s Signature:
I certify that all the information I have provided above is true and complete to the best of my knowledge. I understand
that I will not be paid for this professional volunteer assignment.
Volunteer (Print name):
Date:
Volunteer’s Signature:
I have read Board Policies 3410, 3430, 3720 (found on the Human Resources pag
e link above)
Units:
Birthdate:
Parent/Guardian Signature (if volunteer is under 18):
Date:
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