Members may serve a limited portion of their service term with state agencies, tribal government, or charitable organizations other than their sponsoring organization. Please read the alternative service policy before submitting your alternative service form.

POL#122- managing alternative service (.pdf)
Alternative service form (.pdf)

This checklist provides important reminders, due dates and special events during the program year.

Annual site staff checklist (.pdf)

Service sites may need to utilize an American Sign Language interpreter when hosting an AmeriCorps member with a hearing impairment. Click the link below for a list of ASL interpreters registered with Washington State.

State of Washington Sign Language Interpreter Resources

Insurance certificate samples to be used as a guide for what should be included on a certificate submitted to WSC.

School districts (risk pools) (.pdf)
Organizations (.pdf)

This form is to be submitted to WSC by a Sponsoring Organization prior to a change in a member’s project site staff during the program year.

Change of site staff form (.pdf)

This form is to be submitted to WSC to document a member’s activities during deployment to aid in disaster response efforts. Reference WSC policy #POL-160, Managing Member Deployment for Disaster Response.

Disaster response field reporting form (.xlsx)

All service-related accidents/injuries need to be reported to WSC/WRC. The effected member completes the first page of the report. Service site staff person completes the second page.

This form does not replace an L&I claim form.

Member incident report (.pdf)

• This form is used twice during the member’s service term to document and acknowledge the member’s progress and performance during their service term.

Member performance evaluation form (.doc)/(.pdf)

*Download and open the form as a pdf to sign electronically.

1,700-hour service terms:

First evaluation due date:

• Due by January 31

Second evaluation due date:

• Members exiting May 31 or later- Due by May 31
• Members exiting before  May 31- Due by member’s exit date

1,200 & 900-hour service terms:

November 1 & November 16 Starts – 

• First evaluation due by January 31
• Second evaluation due by May 31

 December 1 & December 16 Starts – 

• First evaluation due by February 28
• Second evaluation due by May 31

January 2 & January 16 Starts –

• First evaluation due by March 31
• Second evaluation due by May 31

February 1 &  February 16 Starts –

• First evaluation due by May 31
• Second evaluation due by June 30

Use this form with your member to guide conversations and planning around connecting your member’s personal and professional goals with opportunities during their service term, then review during performance evaluations.

Member professional development plan (.pdf)

The Member Service Agreement is the contract between members and WSC for the duration of the service term. It explains  benefits, rights and responsibilities as a WSC AmeriCorps member, as well as the expectations and responsibilities of the Sponsoring Organization.

Member Service Agreement (.pdf)

Pol-125 Managing Limited Teleservice By Members (.pdf)

FRM-125A-Limited-Teleservice-Authorization-and-Verification (.docx)

FRM-125A-Limited-Teleservice-Authorization-and-Verification (.pdf)