VOLUNTEER MOVE/CHANGE PROCESS. Volunteer Action Form is used to complete the following: To change companies or join a second company:

Similar documents
IMMIGRATION Canada. Temporary Resident Visa. Los Angeles and New York City Visa Office Instructions. Table of Contents IMM 5876 E ( )

Dear Student, IMMUNIZATION RECORD INSTRUCTIONS

Action plan: serialisation of Nordic packages focus on Product Codes

2016 CWA Political Action Fund Administrative Procedures Checklist

This standard operating procedure applies to stop smoking services provided by North 51.

NHAIS SIS Communication

Indirect Sales. Proof Policy. Indirect Channel. Version May Author: Credit Risk & Fraud. External version

Huon Logistics Isolation & Lockout Work Instruction 1. LOCKOUT DEVICES 2. LIGHT VEHICLE POSITIVE ISOLATION POINTS - 1 -

CALVIN JOHNSON JR. FOUNDATION 2015 PANCREATIC CANCER RESEARCH SCHOLARSHIP

Assessment Field Activity Collaborative Assessment, Planning, and Support: Safety and Risk in Teams

Record of Revisions to Patient Tracking Spreadsheet Template

How to Get Set Up and Running with NDepend

Rate Lock Policy. Contents

GUIDANCE DOCUMENT FOR ENROLLING SUBJECTS WHO DO NOT SPEAK ENGLISH

Medicare Quarterly Update Instructions

Community Health Worker / Certified Recovery Specialist Training Application

NIA Magellan 1 Spine Care Program Interventional Pain Management Frequently Asked Questions (FAQs) For Medicare Advantage HMO and PPO

Lower Extremity Amputation (LEA) Considerations / Issues

University College Hospital. Pump school Starting on an insulin pump. Children and Young People s Diabetes Service

(Please text me on once you have submitted your request online and the cell number you used)

QP Energy Services LLC Hearing Conservation Program HSE Manual Section 7 Effective Date: 5/30/15 Revision #:

National Imaging Associates, Inc. (NIA) Frequently Asked Questions (FAQ s) For PA Health & Wellness Providers

Thank you for your interest in Pratt Community. College s Electrical Power Technology Program at. Coffeyville. Enclosed you will find a packet which

AUXILIARY AID AND SERVICES PLAN January 2017, Revised- All Rights Reserved

Child s Name: Date of Birth: TAKE THIS SHEET TO EVERY DOCTOR S APPOINTMENT

ACRIN 6666 Screening Breast US Follow-up Assessment Form

Getting Started. Learning Guide. with Continuous Glucose Monitoring for the MiniMed 530G with Enlite. CGM Foundations

Coding. Training Guide

National Imaging Associates, Inc. (NIA) Frequently Asked Questions (FAQs) For Louisiana Healthcare Connections Providers

National Imaging Associates, Inc. (NIA) Frequently Asked Questions (FAQs) For Managed Health Services (MHS)

Dear University of Chicago Student,

WCPT awards programme 2015

SUFFOLK COUNTY COUNCIL. Anti- Social Behaviour Act Penalty Notice. Code of conduct

Bariatric Surgery FAQs for Employees in the GRMC Group Health Plan

Lee County Florida Income Guideline Chart

Meaningful Use Roadmap Stage Edition Eligible Hospitals

Code of Conduct for Employees

Medical Student Immunization Requirements

Patient Name: Address City State Zip Code. H. Phone W. Phone Cell Phone

Annual Principal Investigator Worksheet About Local Context

P02-03 CALA Program Description Proficiency Testing Policy for Accreditation Revision 1.9 July 26, 2017

Using the RC View DAT App

InformationNOW Attendance

Editing Your Corps Page User Guide. BETA Version 1.0. The Salvation Army. Media Office

Commissioning Policy: South Warwickshire CCG (SWCCG)

How to become an AME Online

Humanities and Social Sciences Division. o Work Experience, General. o Open Entry/Exit. Distance (Hybrid Online) for online supported courses

Extended G/L Segment Codes

Instructions and Helpful Information for D-5 Form. Preliminary Approval of Dissertation and Request for Oral Defense (D-5)

2017 PEPFAR Data and Systems Applied Learning Summit Day 2: MER Analytics/Available Visualizations, Clinical Cascade Breakout Session TB/HIV EXERCISE

TABLE OF CONTENTS Glossary of terms Code Pad Diagram 3. Understanding the Code Pad lights.4.

EASTERN ARIZONA COLLEGE Criminal Investigation

OAC 310:681 8/7/2018. Subchapter 1. General Provisions. Subchapter 1. General Provisions. Medical Marijuana Control Program. 310:

NATIONAL SENIOR CERTIFICATE GRADE 12

Completing the NPA online Patient Safety Incident Report form: 2016

For personal use only

NATIONAL WEEK OF DEAF PEOPLE 19 th 25 th October 2013 EVENT QUIDELINES. Equality for Deaf People

Benefits for Anesthesia Services for the CSHCN Services Program to Change Effective for dates of service on or after July 1, 2008, benefit criteria

FDA Dietary Supplement cgmp

Solid Organ Transplant Benefits to Change for Texas Medicaid

Creating and Linking Charge Objects

The ECG app is not intended for use by people under 22 years old.

Corporate Governance Code for Funds: What Will it Mean?

FOLLOW-UP IN-DEPTH INTERVIEW GUIDELINES

Initial Postoperative Knee Care Patella or Quadriceps Tendon Repairs: - Videos are available on Dr. Witty s website: drjeffreywitty.

Interpretation. Historical enquiry religious diversity

Instruction Manual IC ACCESS CONTROL

PET FORM Planning and Evaluation Tracking ( Assessment Period)

Welcome to Third Party Fundraising Medical University of South Carolina Foundation

Obesity/Morbid Obesity/BMI

Improving Surveillance and Monitoring of Self-harm in Irish Prisons

Reportable Incident Decision Process

We offer various exhibiting opportunities to accommodate industry needs and budgets, outlined below:

First, you need to set up your MR filter as illustrated below o Log into Imagecast

World Confederation for Physical Therapy Congress , May Singapore

SCALES NW HEARING PROTECTION PROGRAM

CONSENT FOR KYBELLA INJECTABLE FAT REDUCTION

2017 CMS Web Interface

School Medication Authorization Form. School Grade Teacher. Emergency Phone No: To be completed by the student's physician: Name of Medication:

ITEC Level 3 Diploma in Complementary Therapies. Assignment Guidance Form. Unit 384 Principles and Practice of Complementary Therapies

Alcohol & Substance Misuse Policy. St Mary s CE Academy Trading Company. Date: Spring 2017 Date of Next Review: Summer 2018

PROVIDER ALERT. Comprehensive Diagnostic Evaluation (CDE) Guidelines to Access the Applied Behavior Analysis (ABA) Benefit.

EMC believes the information in this publication is accurate as of its publication date. The information is subject to change without notice.

The Cannabis Act and Regulations

COVERAGE ELIGIBILITY OF SERVICES ASSOCIATED WITH A CANCER CLINICAL TRIAL

Appendix C. Master of Public Health. Practicum Guidelines

Dental Benefits. Under the TeamstersCare Plan, you and your eligible dependents have three basic options when you need dental care.

Susan Wortman, Career Development Center

Finding the right 90 people in 90 days and what to do with them:

DISTRIBUTION: ORGANIZATION WIDE APPROVED BY: VP COMPLIANCE

Solaire Medical Electronic Lock Software

Idaho Naturopathic Medicine 6550 W Emerald, Ste 112 Boise, Idaho Ph: Fax:

Post Distribution Monitoring Report

Novel methods and approaches for sensing, evaluating, modulating and regulating mood and emotional states.

UNM SRMC SLEEP MEDICINE CLINICAL PRIVILEGES.

Q. Questions for paediatric audiology services: 2018/19

2017 CMS Web Interface

MGPR Training Courses Guide

NIR and Immunisation Webinar. Leading-edge software for health professionals

Transcription:

VOLUNTEER MOVE/CHANGE PROCESS Vlunteer Actin Frm is used t cmplete the fllwing: Change name, address, phne number r email Change vlunteer status, e.g. add rank/title, member classificatin change (B t A r Jr. t regular), cmpany transfers, r secnd cmpany membership T change cmpanies r jin a secnd cmpany: Cmplete persnal data, cntact data and actins sectin f the Vlunteer Actin Frm shwing mve frm cmpany X t cmpany Y signed by bth lsing and gaining chief Cmplete Permissin t Release Infrmatin (must be ntarized) Cpy f letter frm Virginia Office f Emergency Medical Services indicating that applicant has been apprved if changing cmpanies Cpy f Driver s License if nne submitted in riginal applicatin DMV Drivers Histry (fr thse ver 18) if nne submitted in riginal applicatin When changing cmpanies a vlunteer physical may be required at the discretin f the vlunteer cmpany r if a physical was never cmpleted with riginal applicatin A new member applicatin may be required if ne is nt n file

All dcuments are submitted t the cmpany recruiter fr review Vlunteer Cmpany wner f Agency License fr the gaining cmpany gives vlunteer an apprved fingerprint card. Vlunteer cmpletes card and btains fingerprints. See slides 3 thrugh 5 fr fingerprint prcessing instructin. Vlunteer Cmpany submits fingerprints t Virginia Office f Emergency Medicine (OEMS) fr apprve/reject decisin. Actin Frm package t New Member Orientatin (NMO) crdinatr with a cpy f the apprval letter frm OEMS During Wednesday night NMO frm 6 t 9 p.m. Weekdays between 8 a.m. and 12 p.m. Vlunteer cmpany president, chief and recruiter are ntified if additinal infrmatin is required.

Instructins fr Cmpleting Fingerprinting Card If frm des nt have a tracking number it will be rejected by EMS 1. Name (NAM) blck: Enter applicant s last name, first name, and middle name in that rder in this space. Be sure t write ut the middle name. Suffix denting senirity (Jr., Sr., III) shuld fllw the name. 2. Als Knwn As (AKA) blck: Enter ther names the applicant has used, especially maiden names and r previus married names. 3. Applicant s Signature blck: The applicant must sign this blck in the presence f the persn taking the fingerprints. 4. Applicant Address blck: Enter the applicant cmplete physical address. 5. Date f Birth (DOB) blck: Enter the applicant s date f birth in the frmat mmddyyyy. 6. Sex blck: F fr female, M fr male.

7. Race (RAC) blck: Select ne f the crrespnding alphabetic cdes: CODE I A B W RACE Native American Asian Black Caucasian/Latin 8. Height (HGT) blck: Enter the applicant s height in feet and inches. Rund ff fractins t the nearest inch. 9. Weight (WGT) blck: Enter the applicant s weight in punds. 10. Clr (EYES) blck: Select the crrect clr frm the table: Clr Cde Clr Cde Clr Cde Clr Cde Clr Black BLK Blue BLU Brwn BRO Gray GRY Multiclr MUL Green GRN Hazel HAZ Marn MAR Pink PNK Unknwn XXX Cde 11. Clr (HAIR) blck: Select the clr frm the table Clr Cde Clr Cde Clr Cde Clr Cde Clr Cde Bald BAL Black BLK Blnde BLN Blue BLU Brwn BRO Green GRN Grey GRY Orange ONG Purple PLE Pink PNK Auburn RED Sandy SDY White WHI //////// //////// //////// /////

12. Place f Birth (POB) blck: Enter the state where the applicant was brn. 13. Scial Security Number (SOC) blck: Enter the applicant s scial security number. 14. Date Fingerprinted blck: Enter the date the applicant is fingerprinted 15. Signature f persn taking fingerprints. The fingerprinter (nt applicant) signs in this blck 16. Emplyer and address blck: Enter the name and address f the licensed EMS agency the applicant is seeing affiliatin; emplyment with, and the mailing address f the licensed EMS agency. 17. Reasn fingerprinted blck: Enter either vlunteer r career EMS agency affiliatin in this blck. NOTE: D nt fld cards at any time. Creases in the fingerprint card will results in them nt being able t be prcessed Items 1-17 abve are all required. Missing infrmatin will results in card nt being able t be prcessed Items 1-17 shuld be entered r printed n the card in black ink ONLY. Once all infrmatin abve is entered cmpletely and fingerprints are btained, send the card t: Virginia Office f Emergency Medical Services 1041 Technlgy Park Drive Glen Allen, VA 23059

Additinal infrmatin abut the backgrund check prcess is available in the FAQ dcument fund in the dcument belw. Click n the link belw FAQ sheet Virginia OEMS (Right click n this link and select Open Hyperlink and then select OK. Click n the Explrer icn which will be flashing t pen the dcument.) Department physical frms sent t vlunteer if new physical required and vlunteer schedules with medical facility Ntificatin sent t vlunteer, vlunteer recruiter, cmpany president and chief when physical is cmplete as necessary Vlunteer is ntified t cme t New Member Prcessing t receive new badges New Member Prcessing is held first and third Wednesday f the mnth 210 Hspital Drive, Warrentn, VA

Ntificatin sent t vlunteer, vlunteer recruiter, cmpany president and chief when change is cmplete NMO Crdinatr mves the vlunteer infrmatin frm ld t new cmpany in the membership data files NMO Crdinatr sends Vlunteer Actin Frm t Fauquier Fire and Rescue main ffice with request t mve riginal vlunteer file frm ld cmpany t new cmpany r indicate member nw belngs t mre than ne cmpany in the vlunteer applicatin file Vlunteer Actin Frm (Right click n this link and select Open Hyperlink and then select OK. Click n the Explrer icn which will be flashing t pen the dcument.)