Forms

Instructions

• Instructions – Enrollment Form
• Instructions – Member Agreement
• Instructions – Exit Form
• Instructions – Time Logs
• Instructions - Setting up an account through the Online System to access the education award
  (This can be done anytime after a member is enrolled but the account will show a $0 balance until the member completes their 300 hours of service).

Enrollment Forms (.pdf)

• Complete 2008-09 Enrollment packet (all the forms below are included in the full packet)
• Enrollment Checklist
• CNCS Enrollment Form
• Member Agreement
• Member Eligibility Verification Form
• Service Site Agreement
• Site Supervisor Agreement
• Criminal Record Check Verification Form
• Criminal Record Check Authorization Form

• Education Placement Guidelines and Verification (This is a useful form created by Pfeiffer University for verifying that an education placement meets the guidelines. This is for internal campus verification and does not need to be returned to NC Campus Compact)

Enrollment Forms (Microsoft Word fillable)

• Enrollment Checklist
• Member Agreement
• Site Supervisor Overview
  (this is not a form but provides a brief program summary to give to Site Supervisor with forms)
• Service Site Agreement
• Site Supervisor Agreement
• Criminal Record Check Verification Form
• Criminal Record Check Authorization Form

Time Log Forms

• Sample Time Log (.pdf) (included in the full enrollment packet)
• Blank Time Log (.pdf) (included in the full enrollment packet)
• Blank Time Log   (Microsoft)
• Cumulative Time Log (For record keeping)  (Microsoft)

Exit Forms (.pdf)

• Exit Checklist
• Site Supervisor Evaluation
• Exit Form

Campus Coordinators: You are NOT the Certifying Official on Part 2 of the Exit Form.  Please leave it blank for the Program Director at NC Campus Compact to complete. 

Exit Forms (Microsoft Word fillable)

• Exit Checklist
• Site Supervisor Evaluation

                                                                             
Non-Completion Form*

• Non-Completion Form

Use this form whenever a student is unable to complete the program.  If the member is inaccessible, only the Campus Coordinator needs to complete it.  If the student IS accessible, they should complete an exit form and non-completion form.  In this case, the form should be signed by both parties.

Please keep in mind that whenever a member does not complete the program, this is a potential loss of a $1000 education award to a student in North Carolina. In some cases, NC Campus Compact is able to refill the slot with another student but not always. Members should make every effort to honor their commitment to complete the program.