Student Community Service Policy 2012 VILLAGE OF NORTH PALM BEACH
STUDENT COMMUNITY SERVICE POLICY
I. PURPOSE
Student Volunteer Community Service for the Village of North Palm Beach provides important
benefits to our local residents and local community. Many local students are required to work a
certain number of school-required community service hours each year. The Village provides a
full range of municipal services including Community Development, Parks and Recreation,
Library, Police, Fire and Public Works (including sanitation). The Village also manages the
North Palm Beach Country Club which includes a Jack Nicklaus designed golf course. In the
spirit of community service, support and interest, the Village thankfully offers a Community
Service Program to local students.
11. POLICY
The Village of North Palm Beach hereby establishes a Student Volunteer Community Service
Program. This program will be managed by the Human Resources Director in conjunction with
all Department Directors. This policy is not designed to replace current staff or eliminate
necessary functions of paid employees, but is designed to supplement and complement existing
staff. Availability of volunteer opportunities is not guaranteed, but will be accommodated
whenever possible. Volunteers must be local Village residents, the children of local Village
residents, or the children of Village employees. School identification must be provided in order
to prove student status. No more than 20 hours of community volunteer service may be
worked by a volunteer during an established Village work week (Sunday - Saturday).
III. PROCEDURE
Interested volunteers must submit a completed Application for Student Volunteer Community
Service (Attachment A) to the Village Human Resources Department at 501 U.S. Highway One,
North Palm Beach, Florida, 33408, FAX (561) 848-3344. Applications can be obtained at the
Village Administration Office or on the web at www.village-npb.org. The Human Resources
Department will screen all applications and forward to the appropriate Department Heads to
determine if there are any appropriate volunteer opportunities available. Human Resources
will then contact the selected candidates to notify them of the available opportunity. All
volunteers and a parent or guardian will be required to sign a notarized Student Volunteer
Community Service Release Form (Attachment B) and track all hours worked on a Student
Volunteer Community Service Time Sheet Report (Attachment C).
EXAMPLES OF WORK
• Pick up debris and clean in and around shop areas, office buildings, parks, roadways, canals
and parking lots using shovels, pitchforks and other hand tools.
• Park Maintenance, including planting, mowing, watering, repair of irrigation systems, cleaning
of buildings and park structures.
• Light landscaping assistance along swales and canals using rakes, shovels, small hand-tools.
• Performs facility and custodial maintenance as needed including trash collection and
removal.
• Light administrative duties.
• Special events assistance, set-up and tear down equipment.
• Cleaning of Village Equipment.
• Other work may be assigned as required including light general repairs, work under adverse
conditions, maintaining grounds and structures at various locations or other assignments
required by the Village.
IV. PHYSICAL REQUIREMENTS
The physical demands described here are representative of those that must be met by an
volunteer to successfully perform the essential functions of this job. Reasonable
accommodations may be made to enable individuals with disabilities to perform the essential
functions. While performing the duties of this job, the volunteer may be required to engage in
the following activities: sitting, standing, walking, climbing, crouching, crawling, stooping,
kneeling or balancing; reaching with arms; using hands and fingers to handle, feel, or operate
objects, tools or controls; talking, hearing and smelling. The volunteer must occasionally lift
and/or move up to 80 pounds. Specific vision abilities required by this job include close vision,
distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.
V. WORK ENVIRONMENT
While performing the duties of this position, the volunteer works in outdoor conditions, near
and on machinery, or in high precarious places. The volunteer will likely be exposed to
hot/dry/wet/ humid/cold conditions. The volunteer will occasionally be exposed to fumes,
airborne particles, chemicals, vibration and other potential hazards associated with the
maintenance and/or construction of roads and drainage works and other types of construction.
Manual dexterity is necessary in order to manipulate machinery and tools. The noise level in
the work environment is quiet to moderate, but can be high under certain circumstances.
Hand-to-eye coordination is necessary to operate various tools and equipment.
VI. AT-WILL
This program has been created and formulated specifically for local student volunteers. All
volunteers are considered at-will voluntary workers. All volunteer hours performed will be
worked strictly on an unpaid basis, with no exceptions. The Village expressly reserves the right
to discharge any volunteers for any reason, with or without cause, and without notice. Nothing
in this policy confers the right to any volunteer to continue with this program. Participation in
this program does not constitute employee status for any volunteer.
Attachment A
40 VILLAGE OF NORTH PALM BEACH
"THE BEST PLACE TO LIVE UNDER THE SUN"
APPLICATION FOR STUDENT VOLUNTEER COMMUNITY SERVICE
In accordance with the provisions of the Americans w/Disabilities Act (ADA),
this document may be requested in an alternate format.
PLEASE PRINT LEGIBLY IN INK and COMPLETE IN FULL.
Date:
Name:
Street: Apt. #
City: State: Zip Code:
Cell Phone: ( ) Home Telephone: ( )
Are you legally authorized to work in the United States? (Proof will be required)
❑ Yes
❑ No
Are you currently a full-time student?
❑ Yes
❑ No
If"yes", please state the name of the school, and current student year attending:
Are you related to a current Village Employee?
❑ Yes
❑ No
If"yes", please state name, relationship, and department employed:
Date available for work:
Days/Times able to work:
Are you able to perform the essential job functions of the position for which you are applying?
(The job description is available for review). Yes No
Do you need any special accommodations to perform the essential functions of this job?
Yes No
501 U.S. HIGHWAY 1,NORTH PALM BEACH,FL 33408-4902 • (561) 841-3380 • FAX (561) 848-3344
Attachment A
REFERENCES
Name and Mailing Address Occupation Phone w/Area Code
FOR ALL APPLICANTS:
hereby certify that the answers given to the foregoing questions and statements are true. I authorize
the Village of North Palm Beach to investigate and verify any or all of the information contained in this
application. I understand that any misrepresentation of facts will be cause for dismissal or may disqualify
me from consideration. Further, I understand and agree that any community service project is for no
definite period and may be terminated without previous notice. I acknowledge and agree that if at any
time I am subjected to any type of discrimination or harassment, I will contact the Director of Human
Resources or other management representative immediately to obtain assistance in the resolution of
such matters. I understand that the Village has an anti-harassment policy and that the complaint
procedure stated within that policy should be utilized. Further, in accordance with Florida Public
Records Law, Chapter 119, F.S., information provided on this application may be "inspected and
examined by any person desiring to do so, at any reasonable time, under reasonable conditions, and
under supervision by the custodian of the public record or his designee".
Applicant's Signature Date
INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED.
501 U.S. HIGHWAY 1,NORTH PALM BEACH,FL 33408-4902 • (561) 841-3380 • FAX (561) 848-3344
Attachment B
x
VILLAGE OF NORTH PALM BEACH
"THE BEST PLACE TO LIVE UNDER THE SUN"
STUDENT VOLUNTEER COMMUNITY SERVICE
HOLD HARMLESS AGREEMENT
RELEASE & INDEMNIFICATION FORMS
the undersigned, do hereby acknowledge and agree as follows:
In consideration of being permitted by the Village of North Palm Beach (the Village) to perform labor tasks for an on
behalf of the Village in fulfillment of my Community Service requirements, I Hereby agree to indemnify and save
harmless the Village and its agents and employees from and against any and all claims, suits, actions, damages and/or
causes of action arising while performing labor tasks for and on behalf of the Village in fulfillment of my Community
Service requirements, for any personal injury, loss of life and/or damage to property sustained by me or to any other
person resulting from any accident or incident which may occur as a result of my performing labor tasks for and on
behalf of the Village in fulfillment of my Community Service requirements whether by negligence or not, and from and
against any order, judgements, and/or decrees which may be entered thereon, and from and against all costs, attorneys
fees, expenses and liabilities incurred in and about the defense of any such claim. In the event that the Village shall be
made a party to any litigation commenced against me or by me against any third party, then I agree to protect and hold
the Village harmless and pay all costs and attorney fees incurred by the Village in connection with such litigation and for
any appeals thereof.
I assume full responsibility for any risk of bodily injury, death or property damage due to my negligence or otherwise
while performing labor tasks for and on behalf of the Village in fulfillment of my Community Service Requirements.
I agree that this release, waiver, and indemnity is intended to be as broad and inclusive as permitted by the Laws of the
State of Florida and that if any portion of this agreement is held invalid, I agree that the balance shall continue in full
force and effect.
This Release contains the entire agreement between me and the Village and the terms of this Release are contractual
and not a mere recital.
EXECUTED THIS Day ,20
Emergency Contact Name &Tel #
Signature Social Security Number
Parents / Guardian Signature Drivers License Number
SUBSCRIBED AND SWORN to (or affirmed) before me this day of , 20
By STATE OF FLORIDA: COUNTY OF PALM BEACH:
(SEAL)
Notary Signature
Attachment C
THE VILLAGE OF
NORTH PALM BEACH
"THE BEST PLACE TO LIVE UNDER THE SUN"
Student Volunteer Community Service
Time Sheet Report
Week of-
Date Name Time Time Total Workers Supervisors
In Out Hours Signature Signature
COMMENTS:
1. Both the worker and his/her supervisor must sign this time sheet each day the worker reports to the
Village for work.
2. The Supervisor will submit the original time sheet to Human Resources and submit a copy to the
worker.
3. If there are any questions, or if any problems arise during the course of the "workers" services, please
contact the Village's Human Resource Director immediately.
TOTAL HOURS:
Supervisor Signature Date