Fellows contract



The following agreement has been developed for use by AmeriCorps 4-H Environmental Education and serves as an agreement between Iowa State University 4-H Youth Development, the host-site organization, and the AmeriCorps member.

Purpose

It is the purpose of this agreement to delineate the terms, conditions, and rules of membership regarding the participation of [MEMBER NAME] (hereinafter the “member”) in AmeriCorps 4-H Environmental Education (hereinafter the “Program”) and his/her performing of service in cooperation with [NAME OF YOUR ORGANIZATION] (hereinafter referred to as the host-site organization).

I. Minimum Qualifications

The member certifies that he/she is a United States citizen, a national, or legal permanent resident and at least 17 years of age (or at least 16 years of age if the member is an out-of-school youth and a participant in one of two types of youth corps defined under the National and Community Service Act of 1990, as amended). The member understands that service is contingent on the results of a background check. The member has the right to challenge the factual accuracy of the information, if the background check reveals information that would prevent selection into this program.

II. Terms of Service

A. A member’s term of service begins on [DATE] and ends on [DATE]. This term of service may be extended by the member and the program for the following reasons:

1. The member’s service has been suspended due to compelling personal circumstances.

2. The member’s service has been terminated, but a grievance procedure has resulted in reinstatement.

B. A half-time member agrees to serve a minimum of 900 hours within one full year. Quarter time members will serve 450 hours. Minimum time members will serve 300 hours. Regular work hours are Monday through Friday, 7:30 a.m. to 5:30 p.m., and it is expected that, for the most part, the member’s service will occur during those hours. AmeriCorps members are not eligible for accrual of vacation or sick time. Some tasks, (including, but not limited to, outreach activities and programming activities), may require a member to serve during early morning, evening, and/or weekend hours. In addition, some activities (e.g. Days of Service), may require a member to serve during holiday hours. At no time shall a member count 24 hours in a day toward service hours. In the event a member serves at an overnight conference, training, etc., members shall receive credit for all hours of activities as documented on an agenda or official event schedule plus one hour prior and one hour following the officially-scheduled hours if they have set-up and take-down/debrief responsibilities. For example: An event is scheduled from 7 a.m. - 7 p.m., members could accumulate up to 14 hours (including set-up and take down time). If members have "on-call" responsibilities to be available and there is a need during the overnight hours, members will receive two hours of service credit for each time they are called to respond (or actual time if it is longer than 2 hours). Otherwise members will not receive service hours for time spent in an "off-duty" status. 

C. It is the member’s responsibility to communicate and work with the site supervisor and Program Coordinator to complete this commitment within the agreement service period noted above. Of these hours, a maximum of twenty percent (20%) may be spent in training (45 CFR § 2520.50) and a maximum of ten percent (10%) may be spent fundraising (45 CFR § 2520.45).

D.

Please check one box: I am enrolling as a half-time member

I am enrolling as a quarter-time member

I am enrolling as a minimum-time member

E. The member understands that to successfully complete the term of service and to be eligible for the education award, he/she must complete at least 900/ 450/ 300 hours of service through the entire duration of the above term of service, satisfactorily complete pre-service and host-site orientation and training and attend all mandatory 4-H Environmental Education Program events. A member who anticipates having difficulty completing the required number of hours should notify the Program Coordinator immediately to arrange opportunities for completing the required hours during the term of service.

F. In order to be eligible for additional terms of service a member must successfully complete their previous term of service. This includes:

• completing the required number of hours

• satisfactorily completing all assignments, tasks, and projects communicated at the beginning of the term of service

• completing a letter of application stating why they should be considered for another term of service and what they accomplished during their year of service (if applying at a different host site)

G. The member understands, however, that the mere eligibility for additional terms of service does not guarantee selection or placement.

III. Benefits

A. The member will receive the following benefits from the Program:

| | | | | |

|STATUS |Stipend |HEALTH CARE |CHILD CARE |EDUCATION AWARD |

| | | | | |

|Half-Time |Maximum $7,235 |No |No |$2,960* |

| | | | | |

|Quarter-Time |Maximum $3,635 |No |No |$1,566.14* |

| | | | | |

|Minimum-Time |Maximum $2,423 |No |No |$1,252.91* |

*Contingent upon AmeriCorps funding and successful completion of service described within this contract

1. The living allowance, to be paid monthly during the term of service, is subject to federal and state tax withholdings and is deducted directly from the member’s monthly living allowance.

2. Full-time members are entitled to health care coverage as described in Insurance Packet, until termination of service. If health care coverage is waived members will provide Program Coordinator with a copy of the member’s alternative health care coverage.

If eligible, full-time members may request a childcare subsidy, the terms of which are described in the Childcare Packet, until termination of service. Members are not eligible for benefits while under suspension. However, if a member is put in a temporary suspended status and meets all the below requirements, that member may be eligible to receive up to 12 consecutive weeks of continued benefits:

The Member may not be suspended for cause and/or other disciplinary actions (an example of a qualifying suspension would be if a member was given a temporary suspension under the Family Medical Leave Act);

The Member must intend to return to service; Member must certify he/she needs the continued benefit to be able to return to service.

3. Forbearance is available for qualified student loans.

4. AmeriCorps members are not eligible for unemployment insurance.

Loan Forbearance and Interest Payments

The member is eligible to have the repayment of certain student loans postponed during their term of service. Members must request forbearance from their loan holders with the National Service Forbearance Request Form. The National Service Trust does not grant forbearances; the loan holders do. Members whose loans are in current default status are not eligible for this benefit. If the member has received forbearance on a qualified student loan during the term of service, upon completion, the National Service Trust will repay a portion or all of the interest that accrued on the loan during the term of service. However, if the member leaves for non-compelling reasons, even if the loan was in forbearance, the Trust will not pay the interest. The interest paid will be taxed as income.

Public Service Loan Forgiveness (PSLF) and Income-Based Repayment (IBR)

As an alternative to putting qualified student loans into forbearance, members serving a fulltime AmeriCorps position may be eligible to count the regular student loan payments made during their service toward the PSLF program. Members may elect to participate in the IBR plan in order to make their loan payments more affordable during service. Under IBR, loan payments may be as low as $0 per month. Additionally, loan payments made using the Segal Education Award may count toward PSLF, even if the loan(s) are put into deferment or forbearance during service. The PSLF program allows an exception for AmeriCorps alums to make a lump sum payment using the AmeriCorps Segal Education Award and receive credit for up to 12 qualifying payments for PSLF. The number of payments for which a member will receive credit is determined by dividing the amount of the lump sum payment by the scheduled full monthly payment amount, (but members may not receive credit for more than 12 monthly payments toward the PSLF payment requirement).

See for additional reference.

B. Upon successful completion of the member’s term of service, the member will receive an education award from the National Service Trust.

1. Prior to using the education award, the member agrees (in the event the member has not yet received a high school diploma or its equivalent including an alternative diploma or certificate for individuals with learning disabilities) to obtain a high school diploma or its equivalent.

2. The member understands that his/her failure to disclose to the program any history of having been released for cause from any other AmeriCorps program will render the member ineligible to receive the education award.

C. If the member has received forbearance on a qualified student loan during the term of service, the National Service Trust will repay a portion or all of the interest that accrued on the loan during the term of service.

D. The member is responsible for scheduling days off with the host-site supervisor and should provide a minimum of two weeks notice before asking for any personal days. Vacation, holidays and sick time does not count toward hours needed to complete your service.

E. The member will not be required to serve on observed holidays at the host-site.

IV. Code of Conduct

A. The member is expected, while acting in an official capacity as an AmeriCorps member, to at all times:

1. Demonstrate mutual respect toward others.

2. Direct concerns, problems, and suggestions to host-site supervisor.

3. Follow all policies and procedures of the host-site organization

4. While charging time to AmeriCorps program, accumulating service or training hours, or otherwise performing activities supported by the AmeriCorps program or the Corporation, staff and members may not engage in the prohibited activities listed in Attachment A. Volunteers recruited and/or managed by AmeriCorps members may not engage in the listed prohibited activities. Members are responsible for reporting, to the Program Coordinator, any request to perform activities listed under Nonduplication/ Nondisplacement in Attachment A.

B. At no time may the member:

1. Engage in any activity that is illegal under local, state, or federal law.

2. Engage in activities that pose a significant safety risk to others.

C. The member understands that the following behaviors, but not limited to, constitute a violation of the program’s rule of conduct:

1. Unauthorized tardiness.

2. Unauthorized absences. (Members may be excused for illness but are still required to notify the host-site supervisor as soon as possible before scheduled hours. If a member is absent because of illness for three consecutive days, a written excuse from a medical doctor is required.)

3. Repeated use of inappropriate language (i.e. profanity) at a service site.

4. Engaging in activity that may physically or emotionally damage other members of the program or people in the community.

5. Possessing or using any illegal drugs during the term of service.

6. Being under the influence of alcohol or any illegal drugs during the performance of service activities.

7. Failure to notify the program of any criminal arrest or conviction that occurs during the term of service.

D. For violating the above stated rules in Section VI, and failing to meet the standards of behavior and work as expressed above and by the member’s supervisor, the member may be terminated. The member will be notified of his/her inability to meet these standards in the following ways:

Step 1: Speak to the member about the issue and call the AmeriCorps Program Coordinator to inform of the situation. Create a note with a description of what was said and done for the member’s file and share the written description with the Program Coordinator.

Step 2: Give a verbal warning to the member, clearly describing the problem and steps necessary for improvement. Document the conversation by creating a note for the member’s file and share it with the Program Coordinator.

Step 3: If the problem persists, give a written warning describing the behavior. In this written warning, describe the steps the member must make that are necessary for improvement. The supervisor should also describe procedures taken if behavior does not improve. This could include a suspension from service after consulting with the Program Coordinator. Share the written description with the Program Coordinator.

Step 4: If there is still no improvement in the member’s behavior, the member may be released from his/her service term for cause after the Program Coordinator has been notified. The Program Coordinator and site supervisor both must concur that release for cause is appropriate

E. The Program reserves the right to release the member for cause if, in the judgment of the Program Coordinator, his/her conduct undermines the effectiveness of the Program or the project to which he/she is assigned. If a member is exited for unsatisfactory performance, the Program Coordinator or designee will notify the member they are not eligible for future terms of service.

F. The Program may release the member for cause if, in the judgment of the Program

Coordinator, he/she repeatedly or periodically continues to demonstrate inappropriate behavior by engaging in a pattern of conduct inconsistent with Program expectations.

G. The Member understands that he/she will be either suspended or released for cause in accordance with paragraphs (A) and (B) of section VI of this agreement.

H. Under the Drug-Free Workplace Act, you must notify the Program Coordinator within 5 days if you are convicted under any criminal drug statute. Your participation in the Program is conditioned upon compliance with this notice requirement.

V. Release From Terms of Service

A. The member understands that he/she may be released for the following two reasons:

1. For cause, as explained in paragraph (B) of Section VII (this section); or

2. For compelling personal circumstances as defined in paragraph (C) of Section VII.

B. The Program will release the member for cause for the following reasons:

1. The member has dropped out of the program without obtaining a release for compelling personal circumstances from the appropriate program official;

2. During the term of service the member has been convicted of a violent felony or the sale or distribution of a controlled substance;

3. The member has committed a fourth offense in accordance with paragraph (D) of section VI of this agreement; or

4. Any other serious breach that in the judgment of the Program Coordinator undermines the effectiveness of the program.

C. The Program may release the member from the term of service due to compelling personal circumstances if:

1. The member has a serious injury or illness that makes completing the term impossible.

2. There is a serious injury, illness, or death of an immediate family member.

3. The member is drafted by the Armed Services of the United States.

4. Some other circumstance occurs that makes it impossible or very difficult for the member to complete the term of service and the program deems that circumstance to be compelling.

D. The Program will suspend the member’s term of service for the following reasons:

1. During the term of service the member has been charged with a violent felony or the sale or distribution of a controlled substance. (If the member is found not guilty or the charge is dismissed, the member may resume his/her term of service. The member, however, will not receive back living allowances or credit for any service hours missed.)

2. During the term of service the member has been convicted of a first offense of possession of a controlled substance. (If, however, the member demonstrates that he/she has enrolled in an approved drug rehabilitation program, the member may resume his/her term of service. The member will not receive back living allowance or credit for any service hours missed.)

E. The program may suspend the member’s term of service for violating the rule of conduct provisions in accordance with the rules set forth in paragraph (C) of section VI of this agreement.

F. If the member discontinues his/her term of service for any reason other than a release for compelling personal circumstances, the member will cease to receive the benefits described in paragraph (A) of section IV and will receive no portion of the education award or interest payments.

G. If the member discontinues his/her term of service due to compelling personal circumstances as described in paragraph (C) of section VII of this agreement, the member will cease to receive benefits described in paragraphs (B) and (C) of section IV.

H. Under no circumstance is an AmeriCorps member eligible for unemployment insurance.

VI. Grievance Procedures

A. The member understands that the Program has a grievance procedure, as outlined in Attachment B, to resolve disputes concerning the member’s service assignment, service evaluation, suspension, or dismissal.

Member’s Initial: _______________

B. The member understands that as a program participant, he/she may file a grievance in accordance with the Program’s grievance procedure, as outlined in Attachment B.

Member’s Initial: _______________

VII. Member Expectations

As an AmeriCorps participant with AmeriCorps 4-H Environmental Education, the member understands that he/she will serve in accordance with the attached Service Description and in addition (please initial):

1. _____Will track weekly service hours, and log service accomplishments via the Program’s reporting instruments. Member will also submit these logs to the host-site supervisor for approval. Tracking logs must be submitted no later than the 5th of each month for service provided during the previous month. If not submitted, the Program Coordinator reserves the right to withhold members’ living allowances until tracking logs are received.

2. _____Will complete quarterly impact reports.

3. _____Will submit monthly reflection and a reflection paper at the end of the service term.

4. _____Will report directly to his/her host-site supervisor on a regularly scheduled basis.

5. _____Will attend all mandatory scheduled in-service training, retreats, and events sponsored by AmeriCorps 4-H Environmental Education. (If a member is unable to attend a mandatory training or event, he/she is required to obtain approval from the Program Coordinator and complete written assignments, as provided by the Program Coordinator, pertaining to each of the training topics. The Program Coordinator reserves the right to not exit a member from the Program until the member has either attended all required state level training or has successfully completed corresponding written training assignments.)

6. _____Will evaluate program effectiveness and work with supervisor to implement ideas for environmental programmatic changes or in-service training.

7. _____Will inform the Program Coordinator of any changes in his/her host-site service plan.

8. _____Will respond to all requests of AmeriCorps 4-H Environmental Education staff and regularly communicate with other Program members, 4-H Youth Development staff, and host site staff via internet, phone and fax.

9. _____Will abide by all policies and procedures of the Program and host organization.

10. _____Will use the host-site supervisor as their point of contact for all programmatic and service-oriented questions.

11. _____Will not receive credit for time volunteered outside of the Host Site Organization without prior approval of the host-site supervisor and the Program Coordinator and no more than 40 hours may be served in this capacity during any given week.

VIII. Drug-Free Workplace Policy

The AmeriCorps 4-H Environmental Education program provide a drug-free workplace and environment. In this connection, the program prohibits the unlawful manufacture, distribution, dispensation, possession, or use of any controlled substance in the workplace. The term “controlled substance” means a controlled substance in schedules I through V of section 202 of the Controlled Substance Act (21 U.S.C. 812). The term “controlled substance” refers to all illegal drugs used without a physician’s order, and it does not prohibit taking prescribed medication under the direction of a physician.

Individuals found to be in violation of this policy are engaged in serious misconduct and subject to disciplinary action up to and including release from the program. All members will, as a condition of their enrollment, abide by the terms of this statement. In addition, the Program Coordinator must be notified within 5 days of any criminal drug statute conviction.

All members placed through AmeriCorps 4-H Environmental Education will also be subject to enforcement of any drug policies established at their placement site. It is the responsibility of the member to read and understand any existing policy at the individual host-site.

IX. Non-Discrimination

A. The member understands that Iowa State University Extension 4-H Youth Development may not lawfully discriminate against any member or service recipient on the basis of race, color, national origin, sex, age, religion, political affiliation or disability.

B. It is the responsibility of site supervisors to provide reasonable accommodations to members with disabilities. It is the responsibility of members with disabilities to request reasonable accommodations from their site supervisors during their term of service.

X. Amendments to This Agreement

This agreement may be changed by written consent by both parties.

XI. Authorization

The member and Program hereby acknowledge by their signatures that they have read, understand, and agree to all terms and conditions of this agreement and any attached policies and procedures. (If the member is under the age of 18 years old, the member’s parent or legal guardian must also sign the attached document.) By signing this contract, the member will also certify, under penalty of law, that she/he has a high school diploma or equivalency certificate. Before signing the agreement please check and complete the appropriate information in the table below.

|Degree Held |Mark Appropriate |Institution and Location Where Degree |Date of Completion |

| |Certification |Completed | |

|High School Diploma | | | |

|High School Equivalency Certificate | | | |

|Expect to complete high school | | |Include expected date of completion |

|diploma/equivalency before using education | | | |

|award | | | |

___________________________________________________________________________________

Signature Signature

Bobbi Minard

___________________________________________________________________________________

AmeriCorps Member Name (Printed) AmeriCorps 4-H Program Coordinator Name

___________________________________________________________________________________

Date Date

For Parent of Guardian of members under 18 years of Age:

I, the undersigned parent/guardian of __________________________________ understand the responsibilities and benefits associated with AmeriCorps. I authorize my son/daughter/legal ward to participate in AmeriCorps including educational, training, and service related activities provided by AmeriCorps 4 H Environmental Education Program.

I authorize the exchange of information between the AmeriCorps sponsor, (site name)________________ _____________________________ and the Corporation for National and Community Service which is relevant to successful participation in the AmeriCorps program.

I grant permission for the AmeriCorps sponsor to provide or arrange the necessary medical assistance for my son/daughter/legal ward if I cannot be immediately reached in the event of an accident or illness. I have listed any illnesses, allergies, medical conditions or disabilities that might affect participation in the AmeriCorps program or require medical attention.

____________________________________________________

Parent/Legal Guardian Name (if applicable)

____________________________________________________ ______________________

Signature Date

Attachment A

Prohibited Activities (45 CFR §§ 2520.65, § 2520.40, § 2520.45 )

While charging time to the AmeriCorps program, accumulating service or training hours, or otherwise performing activities supported by the AmeriCorps program or CNCS, staff and members may not engage in the following activities (see 45 CFR §§ 2520.65, § 2520.40, § 2520.45) :

a. Attempting to influence legislation;

b. Organizing or engaging in protests, petitions, boycotts, or strikes;

c. Assisting, promoting, or deterring union organizing;

d. Impairing existing contracts for services or collective bargaining agreements;

e. Engaging in partisan political activities, or other activities designed to influence the outcome of an election to any public office;

f. Participating in, or endorsing, events or activities that are likely to include advocacy for or against political parties, political platforms, political candidates, proposed legislation, or elected officials;

g. Engaging in religious instruction, conducting worship services, providing instruction

as part of a program that includes mandatory religious instruction or worship, constructing or operating facilities devoted to religious instruction or worship, maintaining facilities primarily or inherently devoted to religious instruction or worship, or engaging in any form of religious proselytization;

h. Providing a direct benefit to—

i. A business organized for profit;

ii. A labor union;

iii. A partisan political organization;

iv. A nonprofit organization that fails to comply with the restrictions contained in section 501(c)(3) of the Internal Revenue Code of 1986 related to engaging in political activities or substantial amount of lobbying except that nothing in this section shall be construed to prevent participants from engaging in advocacy activities undertaken at their own initiative;

v. An organization engaged in the religious activities described in paragraph (g) of this section, unless Corporation assistance is not used to support those religious activities;

i. Conducting a voter registration drive or using Corporation funds to conduct a voter registration drive;

j. Providing abortion services or referrals for receipt of such services; and

k. Such other activities as the Corporation and ICVS may prohibit including:

i. Raising funds for living allowances or for an organization's general (as opposed to project) operating expenses or endowment;

ii. Writing a grant application to the Corporation or to any other Federal agency.

iii. An AmeriCorps member may spend no more than ten percent of his or her originally agreed-upon term of service, as reflected in the member enrollment in the National Service Trust, performing fundraising activities.

AmeriCorps members may not engage in the above activities directly or indirectly by recruiting, training, or managing others for the primary purpose of engaging in one of the activities listed above. Individuals may exercise their rights as private citizens and may participate in the activities listed above on their initiative, on non-AmeriCorps time, and using non-Corporation funds. Individuals should not wear the AmeriCorps logo while doing so.

AmeriCorps members may raise resources directly in support of your program's service activities. Examples of fundraising activities AmeriCorps members may perform include, but are not limited to, the following:

(1) Seeking donations of books from companies and individuals for a program in which volunteers teach children to read;

(2) Writing a grant proposal to a foundation to secure resources to support the training of volunteers;

(3) Securing supplies and equipment from the community to enable volunteers to help build houses for low-income individuals;

(4) Securing financial resources from the community to assist in launching or expanding a program that provides social services to the members of the community and is delivered, in whole or in part, through the members of a community-based organization;

(5) Seeking donations from alumni of the program for specific service projects being performed by current members.

AmeriCorps members may not:

(1)Raise funds for living allowances or for an organization’s general (as opposed to project) operating expenses or endowment;

(2) Write a grant application to the Corporation or to any other Federal agency.

Nonduplication/Nondisplacement (45 CFR §§ 2540.100)

(e) Nonduplication. Corporation assistance may not be used to duplicate an activity that is already available in the locality of a program. And, unless the requirements of paragraph (f) of this section are met, Corporation assistance will not be provided to a private nonprofit entity to conduct activities that are the same or substantially equivalent to activities provided by a State or local government agency in which such entity resides.

(f) Nondisplacement. 45 CFR §§ 2540.100 (1) An employer may not displace an employee or position, including partial displacement such as reduction in hours, wages, or employment benefits, as a result of the use by such employer of a participant in a program receiving Corporation assistance.

(2) An organization may not displace a volunteer by using a participant in a program receiving Corporation assistance.

(3) A service opportunity will not be created under this chapter that will infringe in any manner on the promotional opportunity of an employed individual.

(4) A participant in a program receiving Corporation assistance may not perform any services or duties or engage in activities that would otherwise be performed by an employee as part of the assigned duties of such employee.

(5) A participant in any program receiving assistance under this chapter may not perform any services or duties, or engage in activities, that— (i) Will supplant the hiring of employed workers; or (ii) Are services, duties, or activities with respect to which an individual has recall rights pursuant to a collective bargaining agreement or applicable personnel procedures.

(6) A participant in any program receiving assistance under this chapter may not perform services or duties that have been performed by or were assigned to any— (i) Presently employed worker; (ii) Employee who recently resigned or was discharged; (iii) Employee who is subject to a reduction in force or who has recall rights pursuant to a collective bargaining agreement or applicable personnel procedures; (iv) Employee who is on leave (terminal, temporary, vacation, emergency, or sick); or (v) Employee who is on strike or who is being locked out.

Signature:_______________________________________ Date: _______________

Attachment B

Grievance Procedure

Members, staff, sub grantees, and other interested parties involved in the Iowa AmeriCorps Program administered through the Iowa Commission on Volunteer Service (ICVS), who wish to file a grievance, shall follow the procedures set forth below. Nothing herein shall prohibit the complainant from filing a grievance with other state or federal agencies or bargaining units.

Informal Resolution

The member and program will resolve the matter informally whenever possible. If this cannot occur, the complainant may seek resolution through alternative means of informal Alternative Dispute Resolution (ADR), such as mediation or facilitation.

1. The opportunity for ADR must be provided within 45 days of the alleged occurrence.

2. At the initial session, the aggrieved must be informed in writing of his/her right to file a grievance and of their right to arbitration.

3. A neutral, third party must facilitate the proceedings, and function specifically to aid the parties in resolving the matter through a mutually achieved and acceptable written agreement. The neutral third party may not compel a resolution.

4. The proceedings must be informal, confidential, non-binding (unless both parties agree), and the rules of evidence do not apply.

5. If the matter is not resolved within 30 days of initiation, the aggrieved must again be informed in writing of their right to file a formal grievance.

6. If the matter is resolved, and a written agreement is reached, the complainant will agree to forgo filing a grievance in the matter under consideration.

Filing a Formal Grievance

The person wishing to file a formal complaint or grievance regarding the program must submit a grievance complaint form (see the AmeriCorps Grievance Form) and use the procedure explained below.

1. Except for complaints alleging fraud or other criminal activity, complaints must be filed in writing and to the grantee within one year of the date of the alleged occurrence.

2. The grantee will conduct a hearing no later than 30 days after the filing of a formal grievance.

3. A decision on any such filed grievance will be made no later than 60 days after the filing. However, extensions may be granted for good faith.

4. Complaints should include, to the best extent possible, the following information:

a. The full name, telephone number, and address of the person making the complaint;

b. The full name and address of the party against whom the complaint is made, or other information sufficient to identify the party against whom the complaint is made;

c. A clear and concise statement of the facts, as alleged, including pertinent dates, constituting the alleged violations;

d. The provision of the act, regulations, grant, contract or other agreements under the act believed to have been violated; and

e. The relief requested.

5. If ADR was used, that facilitator may not participate in the formal hearing.

6. No communication or proceeding from ADR may be referred to or used as evidence.

7. The independent arbitrator must be jointly selected.

8. The hearing proceedings must be held within 45 days after the request for arbitration.

9. A decision must be made no later than 30 days after the beginning of the proceeding.

10. If the party filing the grievance prevails, the program must pay the costs incurred through the process. If the program prevails, the program and the aggrieved will evenly split the costs incurred through the process.

Filing an Appeal

1. If there is an adverse decision against the party who filed the grievance or no decision has been reached after 60 days of filing a grievance, the complainant may submit the grievance in binding arbitration before a qualified arbitrator who is jointly selected and who is independent of the interested parties.

2. If the parties cannot agree on an arbitrator within 15 days after receiving a request from one of the parties, the grantor will appoint an arbitrator.

3. An arbitration proceeding must be held no later than 45 days after the request for arbitration. If the arbitrator is appointed by the grantor, the proceeding must occur no later than 30 days after the arbitrator’s appointment.

4. A decision must be made by the arbitrator no later than 30 days after the date the arbitration proceedings began.

5. The decision of the arbitrator is final.

6. The cost of the arbitration proceedings must be divided equally between the parties to the arbitration, unless the party requesting the grievance proceeding prevails. If the aggrieved prevails, the grantee must pay the total cost of the proceedings and reasonable attorney fees of the prevailing party incurred in connection with the proceeding.

7. To enforce the arbitration award, a suit may be brought in any federal district court having jurisdiction over the parties without regard to the amount in controversy.

Suspension of Placement

If a grievance is filed regarding a proposed placement of a member, such placement must not be made unless the placement is consistent with the resolution of the grievance.

Remedies

Remedies for a grievance filed under a procedure established by the grantee may include:

1. Prohibition of placement of a member; and

2. In grievance cases where there is a violation of non-duplication or non-displacement requirements and the employer of the displaced employee is the grantee:

a. Reinstatement of the employee to the position he or she held prior to the displacement;

b. Payment of lost wages and benefits;

c. Re-establishment of other relevant terms, conditions and privileges of employment; and;

d. Any other equitable relief that is necessary to correct any violation of the non-duplication or non-displacement requirements or to make the displaced employee whole.

Signature: ______________________________________ Date: _______________________

Attachment C

National Service Criminal History Check

Acknowledgment of Iowa AmeriCorps 4-H Environmental Education

Criminal Background Check

1). I, ___________________________, an applicant to Iowa AmeriCorps 4-H Environmental Education, understand that my selection into this program is contingent upon a number of factors, including AmeriCorps 4-H Environmental Education’s review of my criminal history.

2). I acknowledge that my eligibility is contingent upon the organization’s review of my (the Member’s) criminal history and sex offense history. In addition to the eligibility criteria established by the program, an individual shall be ineligible to serve if the individual—a) refuses to consent to a criminal registry check or makes a false statement in connection with the program’s inquiry concerning the individual’s criminal history, b) is registered, or required to be registered on a state sex offender registry or the National Sex Offender Registry, or c) has been convicted of murder as defined in section 1111 of title 18, United States Code. The Member has the opportunity to review and challenge the factual accuracy of a result before action is taken to exclude or terminate the Member from the AmeriCorps position.

3). Specifically, as it concerns criminal history:

a. Iowa AmeriCorps 4-H Environmental Education will review whether I have been placed on the National Sex Offender Public Website (NSOPW). If I appear on the NSOPW, I will not be able to participate in the program.

b. Iowa AmeriCorps 4-H Environmental Education will check my criminal history through the Iowa Division of Criminal Investigations.

c. Iowa AmeriCorps 4-H Environmental Education will conduct an FBI fingerprint criminal history check. If I have been convicted of murder or a violent crime against a minor, I will not be able to participate in the program. Existence of criminal conviction/adjudication may or may not, depending on the circumstances, disqualify you from consideration. However, any intentional misrepresentation or omission will disqualify you. The program will make the determination as to whether any misrepresentation was intentional. Do not include minor traffic violations.

d. If I am a resident of another state at the time of my application, to the extent that state permits, Iowa AmeriCorps 4-H Environmental Education will investigate my criminal background there, in addition to checking my background through the Iowa Division of Criminal Investigations.

e. I will provide Iowa AmeriCorps 4-H Environmental Education with permission and/or documents it needs to conduct these background checks.

4). If the AmeriCorps Program Coordinator’s review of the background check reveals information that it determines should prevent my selection into this program, I understand that the program will advise me, in writing, of the proposed determination, and will provide me a copy of the information the program has received (to the extent permitted by law). AmeriCorps 4-H Environmental Education will allow me the opportunity to challenge the factual accuracy of the information, in writing, within five (5) business days of notifying me of its proposed determination. I also understand that I may provide any other written information that I believe will assist AmeriCorps 4-H Environmental Education in making a decision.

5). I acknowledge that I have received a copy of “How Iowa AmeriCorps 4-H Environmental Education Evaluates Criminal History Checks for the AmeriCorps Members.”

Member Signature__________________________________Date______________________

Attachment D

701.7 FELONY DEFINED AND CLASSIFIED.

A public offense is a felony of a particular class when the statute defining the crime declares it to be a felony. Felonies are class "A" felonies, class "B" felonies, class "C" felonies, and class "D" felonies. Where the statute defining the offense declares it to

be a felony but does not state what class of felony it is or provide for a specific penalty, that felony shall be a class "D" felony.

902.1 CLASS "A" FELONY.

Upon a plea of guilty, a verdict of guilty, or a special verdict upon which a judgment of conviction of a class "A" felony may be rendered, the court shall enter a judgment of conviction and shall commit the defendant into the custody of the coordinator of the Iowa Department of Corrections for the rest of the defendant's life. Nothing in the Iowa corrections code pertaining to deferred judgment, deferred sentence, suspended sentence, or reconsideration of sentence applies to a class "A" felony, and a person convicted of a class "A" felony shall not be released on parole unless the governor commutes the sentence to a term of years.

903.1 MAXIMUM SENTENCE FOR MISDEMEANANTS

1. If a person eighteen years of age or older is convicted of a simple or serious misdemeanor and a specific penalty is not provided for or if a person under eighteen years of age has been waived to adult court pursuant to section 232.45 on a felony charge and is subsequently convicted of a simple, serious, or aggravated misdemeanor, the court shall determine the sentence, and shall fix the period of confinement or the amount of fine, which fine shall not be suspended by the court, within the following limits:

a. For a simple misdemeanor, there shall be a fine of at

least sixty-five dollars but not to exceed six hundred twenty-five

dollars. The court may order imprisonment not to exceed thirty days

in lieu of a fine or in addition to a fine.

b. For a serious misdemeanor, there shall be a fine of at

least three hundred fifteen dollars but not to exceed one thousand

eight hundred seventy-five dollars. In addition, the court may also

order imprisonment not to exceed one year.

2. When a person is convicted of an aggravated misdemeanor, and specific penalty is not provided for, the maximum penalty shall be imprisonment not to exceed two years. There shall be a fine of at least six hundred twenty-five dollars but not to exceed six thousand two hundred fifty dollars. When a judgment of conviction of an

aggravated misdemeanor is entered against any person and the court imposes a sentence of confinement for a period of more than one year the term shall be an indeterminate term.

3. A person under eighteen years of age convicted of a simple misdemeanor under chapter 321, 321G, 321I, 453A, 461A, 461B, 462A, 481A, 481B, 483A, 484A, or 484B, or a violation of a county or municipal curfew or traffic ordinance, except for an offense subject to section 805.8, may be required to pay a fine, not to exceed one hundred dollars, as fixed by the court, or may be required to perform community service as ordered by the court.

4. The surcharges required by sections 911.1, 911.2, 911.3, and

911.4 shall be added to a fine imposed on a misdemeanant as provided

in those sections, and are not a part of or subject to the maximums

set in this section.

Attachment E

Photograph and Publicity Consent Release Form

I, _______________________________________, give Iowa AmeriCorps 4-H Environmental Education Program and its fiscal agent, Iowa State University Extension, permission to use my name, likeness, image, voice, and/or appearance as such may be embodied in any pictures, photos, video recordings, audiotapes, digital images, and the like, taken or made on behalf of 4-H Environmental Education activities. I agree that AmeriCorps 4-H Environmental Education has complete ownership of such pictures, etc., including the entire copyright, and may use them for any purpose consistent with the 4-H Environmental Education/ University Extension missions. These uses include, but are not limited to illustrations, bulletins, exhibitions, videotapes, reprints, reproductions, publications, advertisements, and any promotional or educational materials in any medium now known or later developed, including the Internet. I acknowledge that I will not receive any compensation for the use of such pictures, etc., and hereby release Iowa AmeriCorps 4-H Environmental Education and its agents and assigns from any and all claims which arise out of or are in any way connected with such use.

I have read and understood this consent and release.

I give my consent to Iowa AmeriCorps 4-H Environmental Education to use my name and likeness to promote AmeriCorps 4-H Environmental Education, its fiscal agent, and/or their activities.

___________________________________________ __________________

Signature Date

___________________________________________ ___________________

Parent / legal guardian (if age 17) Date

I do not give my consent to Iowa AmeriCorps 4-H Environmental Education to use my name and likeness to promote AmeriCorps 4-H Environmental Education, its fiscal agent, and/or their activities.

___________________________________________ __________________

Signature Date

___________________________________________ ___________________

Parent / legal guardian (if age 17) Date

Attachment F

Iowa AmeriCorps State

Member Benefits

Acknowledgement & Waiver Form

Member name: ______________________________________________________

My member position (please check the appropriate category):

|Full-Time |Part-Time but serving in a Full-Time Capacity |Part-Time serving on a Part-Time basis |

| | | |

For all members:

| |I choose to waive all or part of my living |

| |allowance (initial below): |

|AVAILABLE BENEFITS: | |

|I understand that I may be eligible to receive a living allowance as part of my service in | |

|AmeriCorps. I may choose to waive all or a portion of my living allowance. | |

|I understand that I may be able to put my qualified student loans into forbearance during my term of service with AmeriCorps. If I |

|successfully complete my term, I understand that the interest (or a portion of the interest – if less than full-time) that accumulated on my |

|qualified student loans during my service may be eligible for repayment by the Corporation for National and Community Service. I acknowledge |

|that it is my responsibility to contact my loan provider to verify my eligibility for and to request loan forbearance. I acknowledge that I |

|must contact the Corporation for National and Community Service regarding interest payments on qualified loans. |

For full-time members and for eligible less than full-time members who are serving in a full-time capacity ONLY:

| |I certify that I have alternate insurance |

| |coverage (initial below AND provide proof of |

| |insurance to program coordinator): |

|AVAILABLE BENEFIT: | |

|I understand that I may be eligible to receive healthcare benefits while I am serving in | |

|AmeriCorps. | |

| |I choose to waive the child care assistance |

|AVAILABLE BENEFIT: |(initial below): |

|I understand that I may be eligible to receive child care assistance for qualified dependents. | |

For full-time members ONLY:

|AVAILABLE BENEFIT: |

|I understand that qualified student loan payments made during my full-time term of service in AmeriCorps may count as payments toward the |

|Public Service Loan Forgiveness program. I acknowledge that it is my responsibility to verify my eligibility and to apply for Public Service |

|Loan Forgiveness. |

I acknowledge that I have been made aware of the available benefits for my AmeriCorps position.

Member signature:_____________________________________ Date: _________________

Attachment G

2018-2019

Iowa AmeriCorps 4H Environmental Education:

AmeriCorps Member Service Position Description

[Insert Name of Host Site]

Member: [insert name of AmeriCorps member]

Service Term Length: [Half-time, quarter-time, minimum-time]

Position Title: Iowa AmeriCorps 4H Environmental Education AmeriCorps Member

Reports to: [Insert name of site supervisor]

Position Description:

Part-time AmeriCorps members will serve in school-based and community-based host sites developing and strengthening youth development programs for Iowa youth. Through partnerships with a variety of community entities and volunteers, members’ service positions will be targeted toward ensuring that children and youth have in their lives high quality positive youth development opportunities. Members may assist students in developing youth-identified and organized service learning events such as park beautification and intergenerational story sharing. In partnership with a variety of community volunteers and entities including local businesses, agencies, organizations, and institutions, members may develop enrichment activities to strengthen and sustain out-of-school programming and fulfill the goals of AmeriCorps 4H Environmental Education, emphasizing the 4-H priorities of Healthy Living, Science Technology Engineering and Mathematics (STEM), Citizenship and Leadership, and Environmental Stewardship. Enrichment activities may include career shadowing, citizenship, drama, drug prevention, environmental, health, life skills, nutrition, personal safety, recreational, and technological learning events.

will engage AmeriCorps members to serve between at .

AmeriCorps is a National Service Program committed to meeting the needs of our communities.

Program-Specific Duties

Make connections with individuals and volunteers in the community for program outreach and program enhancement.

Train and assist volunteers (You should state what you’re training and assisting volunteers to do – it cannot be general).

Do NOT list “administrative duties” or “duties as assigned”—this is not allowed by the program

Do not list fundraising

Eligibility and Responsibilities

• Be at least 17 years of age at the commencement of service.

• Have a high school diploma or its equivalent (or be in the process of obtaining one). College coursework, college degree, or equivalent experience preferred.

• Be a U.S. Citizen, national, or lawful permanent resident alien of the United States

• Member will have recurring access to vulnerable populations. Successful completion and clearance of required background checks (including: 1) a nationwide National Sex Offender check; 2) a Statewide Criminal History check; and 3) a fingerprint-based FBI check)

• Ability to serve approximately X-X hours per week for XX weeks from XXX XX, 2018 –XXXX XX, 2019 with the anticipated service schedule weekdays between 8 a.m. and 5 p.m. Occasional nights and weekends, as required for host site needs. No service on holidays is anticipated. Members should serve from an agency office. Serving while at home is not allowed. Vacation time, sick time and holidays are not counted toward the hours needed to complete the term. Of these hours, a maximum of twenty percent (20%) may be spent in training (45 CFR § 2520.50) and a maximum of ten percent (10%) may be spent fundraising (45 CFR § 2520.45).

• Site Supervisors will perform mid-term and end of term evaluations for members during the member’s term of service.

• Participate in 4H AmeriCorps Environmental Education Orientation and Life After AmeriCorps trainings

• Participate in

• Consult with your supervisor if you have any ideas, issues, or concerns, offering analysis and solutions whenever possible.

• Respect confidentiality of involved persons, staff, and AmeriCorps members.

• Provide data necessary for monthly reports as required by the host site/Iowa Department of Public Health within the timeframes provided.

Benefits

For a half-time commitment and (900) hours of AmeriCorps service, the member will receive:

• A taxable living allowance of $7,235 per PROGRAM YEAR

• A $2,960 educational award at the end of a successfully completed service term

Quarter-time commitment and (450 hours) service members will receive:

• A taxable living allowance of $3,635 per PROGRAM YEAR

• A $1,566.14 educational award at the end of a successfully completed service term

Minimum-time commitment and (300 hours) service members will receive:

• A taxable living allowance of $2,423 per PROGRAM YEAR

• A $1,252.19 educational award at the end of a successfully completed service term

All AmeriCorps members will receive:

• Excellent training opportunities

• Student loan forbearance on qualified student loans

• Increased knowledge in environmental practices and stewardship

• Leadership experience and skill development

• Hands-on experience in a professional setting

• Develop a life-long commitment to the value of service to others

I have read the above AmeriCorps and understand my responsibilities.

Member Name:__________________________________________

Member Signature: _______________________________________ Date: ________________

Site Supervisor Name:____________________________________

Site Supervisor Signature:_________________________________ Date: ________________

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AmeriCorps 4-h Environmental Education

Member Service Agreement

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