Community Service Worksite Agreement
Community Service Worksite Agreement
(PHA name and address)
This agreement is a non-financial agreement entered into between _________ Housing Authority and _____________________________________ hereafter referred to as the worksite.
The worksite agrees to provide a supervised learning experience in accordance with the following provisions for the volunteer, _________________________________.
This volunteer will not: (1) substitute during the time covered in this agreement for another employee or displace a paid employee, (2) perform duties involving political activities, (3) perform duties of a personal nature or “favors” for anyone at the worksite, (4) perform activities away from the designated area of the worksite without specific instructions from supervisor, (5) be discriminated against because of race, color, sex, national origin, age, handicap, political affiliation or beliefs, (6) be paid or receive any benefits for the volunteer activity.
This volunteer will: follow appropriate health, safety and accessibility standards for work and training situations in accordance with all applicable local, state and federal laws and regulations and complete the attached time sheet which is to be completed and turned in monthly to ____________Housing Authority.
WHAT IS COMMUNITY SERVICE? Public Housing requires all residents (18 or older) to participate in eight (8) hours of organized activities or educational classes OR perform eight (8) hours of community service (volunteer activities) per month. To be exempted from Community Service the residents must be age 62 or older, disabled or work a minimum of 20 hours per week.
An off-site worksite in the community must be a non-profit organization, have prior approval from _____________Housing Authority in writing, increase self-responsibility of the participating resident, have reasonable supervision and be a valuable experience which benefits the general public.
Off Site Agency: _________________________ Supervisor: ______________________
Address: _______________________________ Worksite Address if different from agency:
_______________________________ __________________________________
Phone: Phone:
__________________________________ ______________________________
Worksite Supervisor Signature Housing Authority Approval
______________________________________ ___________________________
Trainee/Volunteer Signature Date
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