Documents, Guides, and Templates

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Documents, Guides, and Templates

NEW Education Award Amounts 2016-17:

FT Member $5,775
HT Member $2,887
RHT Member $2,200
QT Member $1,527
MT Member $1,222

Member Service Agreements and Position Descriptions

Member Service Agreement Templates: These templates contain the required elements of a member contract and are provided for each type of member service term. These templates must be modified to be program-specific. Areas requiring modification appear in red. The contract should be signed by the member, a program official, and by a parent or guardian for members under 18. The contract must be signed no later than a member’s first day of service.

Service Descriptions: These are sample position descriptions for member service. These position descriptions may be copied into the member service agreeement or may appear separately.

These are ONLY THREE pre-approved position descriptions for full-time members. No other full time member positions can be approved.

 16-17 Service Descrption Full Time Teacher's Aide.doc

16-17 Service Description Full Time Partnership and Vol Coordination.doc

16-17 Service Description Full Time Construction Skills Trainer.doc 


    Member File Documents and Templates

    AmC Member File Checklist: Provides an overview of all items that should appear in a member file. It may be useful to staple this checklist to the inside of each member file and check off items as you add them.

    Additionally, the SAMPLE AmC Member File can provide subgrantees with a reference of the components of the member file, and Member File Audit is a useful tool for self-auditing files

    Eligibility Verification for Covered Positions:YouthBuild USA now requires this form to be completed and included in member files. It outlines and documents the steps necessary to establish member eligibility.

    NSCHC Consent Form: Members must given consent prior to the state and FBI criminal history checks being conducted. This consent is included in the member service agreement, but if you are running checks prior to members signing the agreement, then members should use this form to obtain consent.

    16-17 Sample Member Evaluation: Evaluations should be completed with members midway and at the end of service. Programs may use their own evaulations, so long as they have the required elements. Evaluations are required to include member and staff signatures and dates, as well as the number of hours a member has earned to date. 

    16-17 Monthly Member Hour Log:  Hour logs must be signed and dated by both a member and a supervisor in order to be considered valid.

    Community Service Hours Verification Form: This form may be used to verify those hours a member completes off-site.

    Sample AmeriCorps Application: This is a sample application to be a YouthBuild AmeriCorps member. In most cases, the program's existing application will suffice. It should include questions to determine an applicant's employment and education status prior to the program.

    Member Online Enrollment and Exits

    By Janaury 1, 2016 all programs are required to cease using paper enrollment and exit forms. Members must self-enroll and exit themselves electornically by accessing the My Americorps Portal.

    Member Online Enrollment Snippet: This is a short e-tutorial on how to invite members to self-enroll into the Portal as required. 

    Member Online Enrollment Tutorial: This is a printable guide to helping members self-enroll online.

    Member Online Exit Snippet: This is a short e-tutorial on how to invite members to self-enroll into the Portal as required. 

    Member Online Exit Tutorial: This is a printable guide to helping members complete the exit process online.

    Health Insurance Information (full time members)

    16-17 Health Insurance Verification Form (for full-time members): Please use this form to confirm Full-time AmeriCorps members’ health insurance coverage that meets the minimum CNCS requirements. This verification is NOT valid without attached supporting documentation e.g. a member’s health insurance card.

    Child Care Information (full time members)

    Child Care Acceptance Waiver Form: Full-time AmeriCorps members may be eligible for child care coverage through GAP Solutions. The program is required to make members aware of this benefit.

    Please visit GAP Solutions for additional information about the program.

    NEW! Performance Measure Documentation

    YBAMC Housing Unit Tracking Form: Use this form to tracking housing units repaired, developed, and made safer.

    YBAMC Housing Unit Summary for DYB: Use this form to summarize all housing projects for reporting to DYB.

    YBAMC Digital Divide Tracking Form: Use this form to tracking computers repaired and refurbushed.

    YBAMC Episodic Non-AmC Volunteer Log: Use this form to track volunteers who volunteer one time or infrequently at the program or at program sponsered events.

    YBAMC Recurring Non-AmC Volunteer Log: Use this form to track volunteers who volunteer on a regular basis at the program.

    YBAMC Non-AmC Volunteer Summary Log: Use this form to track total volunteers, total hours, and to ensure volunteers are not reported more than once.

    Program Calendar

    2016-17 Program Calendar: Use this to map out the member hours for each cohort of the program to ensure members have enough hours to earn their education awards.

    Suspensions and Early Release

    Suspensions and Reinstatement SNIPPET: This short video explains when it is appropriate to suspend members from their AmeriCorps service, how to document the suspension, and how to suspend and reinstate the member in eGrants.

    16-17 Suspension and Reinstatement Form.docThis form provides guidance regarding suspensions and will help the program document suspension and reinstatement.

    16-17 Early Release Form: If a member is released from service or leaves the program on their own volition and is not eligible for any portion of the education award, the program should complete this form in order to briefly explain the circumstances.

    Compelling Circumstances Form for Partial Award: If a member needs to exit the program for compelling personal circumstances and is eligible for part of his or her education award, the program should document the circumstance. This form should be accompanied by additional documentation. Third party documentation should be sought to verify compelling personal circumstances whenever possible.

    Exit for Employment

    AmeriCorps Exit for Employment Webinar - Please watch this webinar to understand the requirements of exiting members for employment.

    Partial Award for Employment Waiver Request Form - Fill this out and submit to your portfolio manager by November 20th in order to allow for your program to exit members for employment.

    Exit for Employment Form for Partial Award - Use this form to document when members are exited for employment.