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)

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.

ASL interpreters (.docx)

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.

1st evaluation due date:

• Due by 1/31/24

2nd evaluation due date:

• Members exiting 5/31/24 or later- Due by 5/31/24
• Members exiting before 5/31/24- Due by member’s exit date

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)

If the Sponsoring Organization ascertains that the Member’s position is the same or substantially similar to that of union-represented employees of the Sponsoring Organization or service site, the Sponsoring Organization must obtain and provide written concurrence of the AmeriCorps placement from the local labor organization. This sample statement provides an example of concurrence by a labor organization.

Sample of Union Concurrence Statement (.pdf)

Members will complete this form prior to any alternative service activities. 

Teleservice authorization form