Volunteering Information and Activity Form

08/2014 CL

As the saying goes, “volunteers are not paid because they are worthless, but because they are

priceless.” The selfless acts you perform as a volunteer will have a lifelong effect you as the volunteer

and on the recipients. The faculty hopes this is a stepping-stone to continuing to be involved with your

community after graduation in your new career as a registered nurse.

By participating in volunteer events, you agree to follow these guidelines.

1. Pre-approved ActivitiesAnnouncements and sign-ups for pre-approved activities will be posted on the volunteer bulletin board in the Skills Lab via D2L or my.vcccd email. Skills allowed to be performed, required attire, and the required tools for the event will also be posted.

A. Read the announcement thoroughly. Sign-up after you have confirmed with your own schedule that you are available and qualified for the event. Some events are restricted to certain class levels due to the skill level required at the event.

B. Arrive at the event on time, in the prescribed attire and with the required tools. Bring a Volunteer Activity Form and fill it out.

D. Have the person in charge of your activities at the event sign-off on your Activity Form.

E. As soon as possible after the event, bring the completed Activity Form to faculty Volunteer Coordinator for final sign-off.

F. Keep a copy of the completed and signed form.

2. Individual ActivitiesA list of potential individual activities is posted on the volunteer bulletin board. Other individual activities must be reviewed and approved by the faculty Volunteer Coordinator and nursing faculty as a whole.

A. Meet with the faculty Volunteer Coordinator and request an “Independent Volunteer Activities Approval Slip.”

B. After discussing the event, obtaining approval, and filling out the Approval Slip, you may participate in the independent activity for volunteer credit.

C. Arrive at the event on time, in the prescribed attire and with the required tools. Bring a Volunteer Activity Form and fill it out.

D. Have the person in charge of your activities at the event sign-off on your Activity Form.

E. As soon as possible after the event, bring the completed Activity Form to faculty Volunteer Coordinator for final sign-off.

F. Keep a copy of the completed and signed form.

3. Penalties

08/2014 CL

By participating, you represent Moorpark College, the Moorpark College Nursing Program, and the nursing profession. You are expected to act in a professional manner. This includes professionalism in punctuality, appearance, communication, action, and behavior.

Complaints received by event or activity personnel regarding unprofessional conduct may result in negative hours and a Performance Improvement Contract. Negative hours will be tracked by the Activities Coordinator. Performance Improvement Contracts may restrict future event and activity involvement until behavioral and/or skill remediation is performed.

The nursing faculty reserve the right to decide that a volunteer may not participate in future events.

A. If you discover you are unable to participate for the event you signed up for and it is within 5 days of the event, you must replace yourself with a qualified volunteer.

- a no-show, no-replacement situation will result in negative hours and potentially a performance improvement contract.

B. Falsifying any Activity Form will result in negative hours and a Performance Improvement Contract.

C. Failing to secure approval for an independent activity prior to participating will disallow those hours from being credited.

D. Performing nursing skills without Moorpark College faculty supervision will result in all of the following:

* Negative hours* Performance Improvement Contract* Review by the Moorpark College nursing faculty* Possible discipline by the Moorpark College Nursing Program* If required by law, reporting to the appropriate public authorities regarding the practice of nursing without a license.

4. Extra CreditAt the end of each semester, you may have the opportunity to earn extra credit for having participated in volunteering during that semester.

Only hours performed during the semester may be considered for possible extra credit points.

Awarding of extra credit points for volunteering is at the discretion of your faculty team. Refer to the Moorpark College Associate Degree Nursing Handbook and semester workbooks details on the amount of extra credit points available and restrictions on activities accepted.

5. RecognitionThe Moorpark College nursing program recognizes participation performed during students’ nursing education. Recognition is bestowed to the graduate during the Nursing Pinning Ceremony.

A. You will have kept your Activity Forms throughout each semester. Use the attached form to log each activity’s hours at the end of your final semester.

B. Turn in copies of your Activity Forms and your Log to your class volunteer representative on the date announced.

6. Changes in policy and procedure.The nursing faculty reserves the right to update and change these guidelines at any time. Changes will be posted on the volunteer bulletin board.

08/2014 CL

Volunteer Activity Form

Student:____________________________________Semester: 1 2 3 4

Volunteer Event :___________________________ Event Date:_____________

Location:____________________________________From:______ to_________

Volunteers hours*: ________________

Faculty Volunteer Activities Liaison signature: ___________________ Date ______For consistency: A co-signature from the volunteer activities liaison is required after the event. It is the volunteer’s responsibility to obtain this signature in a timely fashion.

Activities performed:__________________________________________________________

___________________________________________________________________________

Student's Comment:_________________________________________________________

__________________________________________________________________________

Contact Person:_____________________________Phone:___________________

Advisor/Contact person's

Comment:_____________________________________________________________________

________________________________________________________

Contact Person’s Signature:____________________________Date:_______________(Required)

*To receive volunteer hours for an independent volunteer activity: Must first fill out an “Independent Volunteer Activities” form (get one from Christina), AND have the line below signed.

Approved prior to event: ______________________________ Date:_______________

08/2014 CL

Volunteer Hour Totals for Graduation Recognition

Submitted this completed form with your Volunteer Activity Form sheets on the announced date.

Your Name: ______________________ Date Submitted: ____________

Event NameDate of Event

Semester you were in

Hours Earned

       

       

       

       

       

       

       

       

       

       

       

       

       Grand Total:  

Recognition:

20 hrs = certificate40 hours = certificate and pin60 hours = certificate, pin, and token of appreciation

08/2014 CL