Notification of New Program Staff

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Use this form to notify UServeUtah of AmeriCorps program staff changes within your organization. This form should be filled out by the person responsible for hiring and/or on-boarding the new employee. AmeriCorps program staff positions are those that appear on the program budget as either grant funded or match, or that have a role in managing the AmeriCorps program.

Programs are responsible for submitting this form once they have hired a new employee and have established an email and phone number for the employee. If the email or phone number are not yet available, please enter TDB on the corresponding question.

Please contact janessaedwards@utah.gov or gregbates@utah.gov with any question.

Email *

Full name and Title of person submitting notice *

Name of program *

Before proceeding to Section 2 - Please verify that the program will fully complete and adjudicated an NSCHC level background check on the new employee before they were allowed to begin work on the grant?

See pages 31-35 of the UServeUtah Program Director Manual found on the Program Director Resource Page: https://userve.utah.gov/program-director-resources/

Yes

N/A (Staff person not included on grant budget or for fixed amount grants)

Clear form

Never submit passwords through Google Forms.

This form was created inside of State of Utah. Report Abuse

Forms