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Sample Forms

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Sample Forms
Appendix C









Examples of

Volunteer

Tracking Forms



- Non-Professional Volunteer Form

- Professional Volunteer Form

- Board or Committee Reporting Form

- Volunteer Hours Summary Sheet







NOTE: Items in this section noted as “EXAMPLES”

are for illustration purposes only. Their inclusion in

this manual are as examples of good practices, not as

“official” templates.

ABC County Partnership for Children

Receipt Voucher for In-Kind Contribution of NON-PROFESSIONAL Volunteer Services

Name of Volunteer_____________________________________ Month/Year_________________________________________



Address______________________________________________ Project Name________________________________________



City_________________________________________________ Organization_________________________________________



Phone ( )_____________________ ( )____________________

Home Work



Detailed Record of Professional Volunteer Hours Worked

Date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Total Hourly Total Value

Hours Rate*

Volunteer

$16.03 $

Hours

Date 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31



Volunteer

$16.03 $

Hours



TOTAL VALUE: $



1. On the back of this page, please describe the type of volunteer services performed on each of the days noted above.



2. By my signature below, I certify that I served as a volunteer to this organization for the hours as noted above and did not receive compensation for

my services.



Volunteer Signature________________________________ Date___________________________________



3. By my signature below, I acknowledge receipt of the above-mentioned volunteer services.



Authorized Employee___________________________________ Date____________________________________



*Under legislation by the NC General Assembly in 2000, non-professional services will be valued at the statewide average rate as calculated from data

compiled by the Employment Security Commission in the Employment and Wages in North Carolina Annual Report. Based on data in the 2003 report,

the most recent available, the non-professional volunteer rate for FY05 is $16.03 per hour.





Page 1 of 2

ABC County Partnership for Children

Receipt Voucher for In-Kind Contribution of NON-PROFESSIONAL Volunteer Services

Please briefly describe the volunteer services donated to the organization for the current month.



Date Project Description of Volunteer Service









Page 2 of 2

ABC County Partnership for Children

Receipt Voucher for In-Kind Contribution of PROFESSIONAL Volunteer Services

Name of Volunteer_____________________________________ Month/Year_________________________________________



Address______________________________________________ Project Name________________________________________



City_________________________________________________ Organization_________________________________________



Phone ( )_____________________ ( )____________________

Home Work



Detailed Record of Professional Volunteer Hours Worked

Date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Total Hourly Total Value

Hours Rate*

Volunteer

$ $

Hours

Date 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31



Volunteer

$ $

Hours



TOTAL VALUE: $



1. On the back of this page, please describe the type of volunteer services performed on each of the days noted above.



2. By my signature below, I certify that I served as a volunteer to this organization for the hours as noted above and did not receive compensation for

my services.



Volunteer Signature________________________________ Date___________________________________



3. By my signature below, I acknowledge receipt of the above-mentioned volunteer services.



Authorized Employee___________________________________ Date____________________________________

*Volunteers that are providing services for which they would have otherwise have been paid, should value their time based on the salary or fee charged for such services. This hourly rate

must be corroborated through independent documentation. Such documentation could include a copy of the volunteer’s current payroll information or pay stub, fee schedules, salary

studies for the service being offered, etc. The documentation must be more than just a statement by the volunteer in order to meet the audit standards.



**To compute an hourly rate for someone that is paid on an annual salaried basis, take the total salary and benefits and divide by 2080. That amount is the hourly rate to be used in valuing

the individual’s time.



Page 1 of 2

ABC County Partnership for Children

Receipt Voucher for In-Kind Contribution of PROFESSIONAL Volunteer Services

Please briefly describe the volunteer services donated to the organization for the current month.



Date Project Description of Volunteer Service









Page 2 of 2

ABC County Partnership for Children

Summary of Non-Professional Volunteer Hours

July 1, 20XX – June 30, 20XX



Smart Start Activity: ______________________________ For the month of ______________________







Volunteer Name Total Hours Hourly Total

Rate Value



$16.03 $





$16.03 $





$16.03 $





$16.03 $





$16.03 $





$16.03 $





$16.03 $





$16.03 $





$16.03 $





$16.03 $





$16.03 $



$16.03 $



$16.03 $





TOTALS $

ABC County Partnership for Children

Executive Committee Meeting Record of Attendance

Purpose:______________________________________________

Actual Date of Meeting:____________

Actual Time of Meeting:____________

By signing below, the following volunteers attest they served as volunteers to this organization for the hours as

noted above and did not receive compensation for their services.



By my signature below, I acknowledge receipt of the above-mentioned volunteer services.



Employee Signature: Date:



Office Use Only

PRINTED NAME SIGNATURE

Hours Data Entry









Total # of Hours

x Rate $16.03*

= Total Value

*Under legislation by the NC General Assembly in 2000, non-professional services will be valued at the

statewide average rate as calculated from data compiled by the Employment Security Commission in the

Employment and Wages in North Carolina Annual Report. Based on data in the 2003 report, the most

recent available, the non-professional volunteer rate for FY05 is $16.03 per hour.

ABC County Partnership for Children

Non-Professional Volunteer Hours Spreadsheet

July 1, 20XX – June 30, 20XX





Volunteer Names July Aug Sept Oct Nov Dec Jan Feb Mar Apr May June Rate TOTAL



Brown, Rita Mae 5 1 1 8 3 16.03 $288.54



Clark, Mary Higgins 0 0 1 4 0 16.03 80.15



Cornwell, Patricia 2 2 2 2 2 16.03 160.30



Francis, Dick 0 2 0 2 0 16.03 64.12



Grafton, Sue 5 3 7 9 2 16.03 416.78



Le Caree, John 2 2 2 2 2 16.03 160.30



Sanders, Lawrence 1 0 0 0 0 16.03 16.03



16.03



16.03



16.03



16.03



16.03



16.03



16.03



16.03







TOTALS 15 10 13 27 9 0 0 0 0 0 0 0 $1,186.22


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