Application - FVHS Student Services

2015 Youth Service Award Programs
Dear 2015 Youth Service Award Registrant:
This packet includes information and forms you need to submit in order to receive one or more of the awards
presented by the Volunteer Center. The following is a list of requirement for each of the 3 awards.
For All Awards:
 You must be between the ages of 12-18.
 Register on HandsOnTriangle.org by June 30, 2015 for each award you are pursuing.
 Receive positive evaluations from your volunteer supervisors (rating of average or above).
 You can volunteer for more than one agency in order to accumulate hours. However you cannot be
compensated for any of the hours. Remember: stipends or honorariums are forms of compensation.
Hard Corps Award:
 Serve at least 50 volunteer hours during the academic year in one or more agencies registered with
the Volunteer Center. New agencies can register by June 30, 2015.
 Submit time sheets, evaluations and permission forms to the Volunteer Center by June 30, 2015.
Mayor’s Award:
 Serve at least 100 volunteer hours during summer break in one or more agencies registered with
the Volunteer Center. New agencies can register by August 5, 2015.
 Submit the Parent/Guardian Permission Form by June 30, 2015
 Submit all time sheets and evaluations to the Volunteer Center by August 25, 2015.
President’s Volunteer Service Award:
 Serve the number of hours required to meet the age specific eligibility levels to earn either a bronze,
silver, or gold award. Serve in one or more agencies registered with the Volunteer Center. New
agencies can register by August 5, 2015.
 Submit the Parent/Guardian Permission Form by June 30, 2015
 Submit all time sheets and evaluations to the Volunteer Center by August 25, 2015.
 Pay $30 processing fee by August 25, 2015 or apply for the fee to be waived through our limited
financial assistance funds. If you miss the deadline your award will have to be ordered separately, it
may not arrive in time for the ceremony and you will have to pay an additional $10 fee (for which there
is no financial assistance available.)
Submit forms by the deadlines via mail or email:
Volunteer Center
Attn: Youth Service Awards
PO Box 3374
Durham, NC 27702
Email: [email protected]
Volunteer Center
Mail: PO Box 3374, Durham, NC 27702 | Physical: 700 W. Main Street, Durham, NC 27701
[email protected] | p: 919.613.5101 f: 919.613.5154 | TheVolunteerCenter.org
2015 Youth Service Award Programs
How This Works

Set Up Volunteer Opportunity(ies): Find a local nonprofit or public agency where you would like to
volunteer. You can find volunteer opportunities at HandsOnTriangle.org. Click on “advanced search,”
then “appropriate for,” and mark your age range.

When You Volunteer:
Give the attached letter to the volunteer supervisor at the agency where you are volunteering.
Talk with him/her about the process for keeping track of your hours.
Write down your volunteer hours on the attached Volunteer Time Sheet. Remember, you are
solely responsible for keeping track of your hours on the time sheet and having your
supervisor(s) initial each day's record of hours served.
If you are volunteering with more than one agency, you will need to keep a separate time sheet
and evaluation for each agency.

Evaluation: After you complete your volunteer hours, ask your supervisor to complete the attached
Volunteer Evaluation Form. Your supervisor should return the completed evaluation TO YOU in a
sealed envelope in time for YOU to mail it to the Volunteer Center. You are responsible for your
materials arriving at the Volunteer Center by the deadlines. You must receive ratings of average or
above from your supervisor in order to receive an award. If a supervisor gives you a rating that is
below average the hours you served at that agency will not count towards your award.

Submit Application Packet:
Hard Corps Award application packets must be postmarked by June 30, 2015
Mayor’s Award & President’s Award application packets must be postmarked by Aug. 25, 2015,
preferably earlier. To receive the awards in time for the ceremony we must order them the last
week in August. The earlier you send in your application the sooner we can process your order.
Complete application packets must include all of your time sheets and your completed and
signed evaluation forms.
Mail or e-mail your permission forms and completed application packets by the deadlines to:
Volunteer Center
Attn: Youth Service Awards
PO Box 3374
Durham, NC 27702
Email: [email protected]

Award Presentation: Each fall the Volunteer Center hosts the Tomorrow’s Community Leaders Award
Ceremony with the Mayor of Durham. We will send information about the award ceremony to all
students registered to receive an award. Students earning the Mayor’s Award will also receive
information about attending a photo session with Mayor Bill Bell prior to the ceremony.
If you have any questions please contact John Rich
[email protected] or 919-613-5101
Volunteer Center
Mail: PO Box 3374, Durham, NC 27702 | Physical: 700 W. Main Street, Durham, NC 27701
[email protected] | p: 919.613.5101 f: 919.613.5154 | TheVolunteerCenter.org
2015 Youth Service Award Programs
PARENT/GUARDIAN PERMISSION FORM: Due June 30, 2015
Release of Liability and Claims – to be signed by the Youth Service Award Candidate’s parent/guardian
if under 18 years of age:
My son/daughter______________________________ has my consent to participate in the 2015 Youth
Service Award programs. I understand that my son/daughter assumes all risks and hazards of participating in
the volunteer opportunities provided by the 2015 Youth Service Award programs. I release the Volunteer
Center, its agents, officials, and employees from all liability and assume all responsibility.
I affirm that I am the parent/guardian of the above named volunteer and have read and understand the above
information. I grant and assign to the Youth Service Award programs, its governing organizations and
employees, all rights to photographic or videotaped reproductions of my son/daughter. I give consent that such
photographs/videos may be used for advertising or publicity. I further consent that pictures may be reproduced
either partially or in composite.
*See signature instructions below:
Parent/Guardian Signature
Date_____________
X
I have read and understand the information provided to me regarding the 2015 Youth Service Award programs
and will support my son/daughter in meeting his or her goal and honoring his or her commitment to a nonprofit
agency to the best of my ability.
Parent/Guardian Signature
Date_____________
X
Please Type or Print
Parent/Guardian’s Name:
First
Last
Parent/Guardian Phone Number:
Primary
Alternate
Parent/Guardian Email Address:
Student’s Name:
As you want it listed in the program
Student’s Email Address:
Student’s Phone Number:
Primary
Alternate
Mailing Address:
Street
City
State
Zip
Return this form by June 30 via mail or email:
Volunteer Center, Attn: Youth Service Awards, PO Box 3374, Durham, NC 27702
Email: [email protected]
Volunteer Center
Mail: PO Box 3374, Durham, NC 27702 | Physical: 700 W. Main Street, Durham, NC 27701
[email protected] | p: 919.613.5101 f: 919.613.5154 | TheVolunteerCenter.org
2015 Youth Service Award Programs
How to Electronically Sign Parent Permission Form
When you sign the signature line in an Office document, you add both a visible representation of your
signature and a digital signature.
1. In the document, double-click the signature line where your signature is requested.
2. In the Sign dialog box, do one of the following:
To add a printed version of your signature, type your name in the box next to the X.
To select an image of your written signature, click Select Image. In the Select Signature Image dialog
box, find the location of your signature image file, select the file that you want, and then click Select.
To add a handwritten signature (Tablet PC users only), sign your name in the box next to the X by
using the inking feature.
Click Sign.
Donations Welcome
According to the National Resource Center “youth development is the transformation of children into
competent, confident, connected and contributing people of character who are fully prepared and fully
engaged in their communities.” The Volunteer Center programs are designed to provide resources,
education, and motivation to equip young people to develop a legacy of service to the community.
Each year the Youth Service Award programs honor more students, but with less funding. Please
consider making a financial contribution to the Volunteer Center so that together we can invest in
young people, harnessing their potential to improve our communities while developing their skills for
future success.
Secure online donations can be made at TheVolunteerCenter.org or by mailing a check to:
Volunteer Center
P.O. Box 3374
Durham, NC 27702
(Please make checks out to: Volunteer Center)
Thank you for your generosity,
John Rich
Youth and Mentoring
Volunteer Center
Mail: PO Box 3374, Durham, NC 27702 | Physical: 700 W. Main Street, Durham, NC 27701
[email protected] | p: 919.613.5101 f: 919.613.5154 | TheVolunteerCenter.org
2015 Youth Service Award Programs
VOLUNTEER TIME SHEET: Hard Corps Due June 30 | Mayor’s and President’s Due Aug. 25
Hours at multiple organizations may be combined to total your goal number of hours. Hours on one timesheet can apply to multiple service awards.
However, you must copy and complete a separate time sheet for each organization.
Volunteer’s Name:
Awards this time sheet is being applied towards (check all that apply):
Hard Corps___
Mayor’s Award ___
President’s Award ___
Address:
Street
City
State
Zip
Parent/Guardian Phone:
Student Phone:
School:
Grade in Fall 2015 (at the time of the award ceremony):
Organization where volunteer hours completed:
Organization Address:
Street
City
State
Zip
Supervisor’s Name & Title:
Supervisor’s Phone:
Supervisor’s E-mail:
Column B
Column A
Date
# Hours
Volunteered
Total Hours from Column A
Verification
(Supervisor Initials)
Date
# Hours
Volunteered
Total Hours from Column B
TOTAL HOURS (Column A + Column B)
Volunteer Center
Mail: PO Box 3374, Durham, NC 27702 | Physical: 700 W. Main Street, Durham, NC 27701
[email protected] | p: 919.613.5101 f: 919.613.5154 | TheVolunteerCenter.org
Verification
(Supervisor Initials)
2015 Youth Service Award Programs
Dear Volunteer Supervisor,
The Volunteer Center coordinates 3 annual award programs for volunteers ages 12-18 who register on our
website: HandsOnTriangle.org.
Mayor’s Award: 100 or more volunteer hours during summer break
Hard Corps Award: 50 or more volunteer hours during the academic year
President’s Volunteer Service Award: volunteer the number of hours required to meet the age
specific eligibility levels to earn either a bronze, silver, or gold award during 12 consecutive months or a
lifetime achievement award.
These awards are an important way to recognize and honor the young people who faithfully serve your
organization and our community. These awards also give student volunteers an important goal for their
volunteer service, inspiring consistency and dedication. Recognizing a student’s service through these
prestigious awards opens up opportunities for college scholarships and can be included on a student’s resume.
In order to receive these awards student volunteers must earn positive evaluations (average or above)
from their supervisor(s). A negative evaluation will prevent them from receiving the award.
Eligibility for these awards is based upon the volunteer's initiative; however, you can assist your young
volunteer(s) by remembering the following:

Time Sheet: Tracking volunteer hours on the time sheet is the volunteer's responsibility. He/she will
ask you to verify the hours recorded by initialing their time sheet daily. The sheet can be kept at the
volunteer site. You need not feel responsible to pursue the volunteer about keeping up with his/her
hours – we do not want this to become a burden for you.

Evaluation: If for any reason you do not believe that the volunteer will meet the performance criteria
(hours, attitude, quality of work, etc.) necessary for a positive evaluation, please discuss the problem
with the volunteer and seek a solution early in the process. If you do not see the improvements
necessary to receive a rating of at least “Average” please contact John Rich at 919-681-1835 or email
[email protected] as soon as possible. Any rating below “Average” will prevent the hours
served at your organization from being counted toward the student’s award.

Deadlines and Submission: The Volunteer Evaluation Form must be completed by the volunteer’s
supervisor. We appreciate your thoughtful and honest remarks regarding your volunteer’s performance.
If an item on the form is not applicable, please indicate as such. All evaluations should be returned to
the student in a sealed envelope. Students will include it in their completed application package.
Application packages are due:
Hard Corps Award: June 30, 2015
Mayor’s Award: August 25, 2015
President’s Volunteer Service Award: August 25, 2015
Please return the evaluation in a timely fashion so the volunteer can meet the deadline. It is the
volunteer’s responsibility to mail, fax or deliver the application packet to the Volunteer Center.
Thank you for investing in our future by providing a valuable experience for a young volunteer. Please contact
me at (919) 613-5101 or via e-mail at [email protected] if you have any questions about the
Volunteer Center’s 2015 Youth Service Award programs.
Kind regards,
John Rich
Youth and Mentoring
Volunteer Center
Mail: PO Box 3374, Durham, NC 27702 | Physical: 700 W. Main Street, Durham, NC 27701
[email protected] | p: 919.613.5101 f: 919.613.5154 | TheVolunteerCenter.org
2015 Youth Service Award Programs
VOLUNTEER EVALUATION: Hard Corps Due June 30 | Mayor’s and President’s Due Aug. 25
This form must be completed by the volunteer supervisor. When completed please return to the student volunteer in a sealed envelope.
Student Name:
Organization:
Volunteer Supervisor:
Supervisor Phone:
Supervisor Email:
Category
Superior
Above
Average
Average
Below
Average
Poor
Not
Applicable
Dependability
Attitude
Quality of work
Performance of Duties
Ability to work with
staff & clients
Ability to work with
other volunteers
Leadership qualities
OVERALL
EVALUATION
Please use the space below to provide additional comments and/or tell us a story about this volunteer that
could be included in publicity materials or funding requests.
I verify that the student above did not receive compensation for his/her work with my organization.
Supervisor’s Signature:
Date:
Questions? Contact John Rich at 919-613-5101 or [email protected]
Volunteer Center
Mail: PO Box 3374, Durham, NC 27702 | Physical: 700 W. Main Street, Durham, NC 27701
[email protected] | p: 919.613.5101 f: 919.613.5154 | TheVolunteerCenter.org