Occasional Volunteer Time Sheet - Free Download
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Regular and Occasional Volunteer Time Sheet
James A. Haley Veterans’ Hospital (673), Tampa, FL
NOTE: (This sheet is to be completed for various volunteer visits/activities for either regularly scheduled volunteers unable to access the sign-in kiosk in Escort, Room 2A-215a,
or by Occasional Volunteers who have not gone through the complete Volunteer Application Process.)
By signing below, these Occasional Visitors agree, for an indefinite period, with the following statement:
I hereby waive all claims to monetary benefits for services rendered as a volunteer worker on a “without compensation basis.” I understand this waiver applies only to
compensation for specific services rendered in the Voluntary Service Program and has no relation to any compensation for other services or benefits to which I may be entitled.
(NOTE: VA has entered into this agreement by the authority of 38 U.S.C., Section 513.
This agreement may be canceled by either party upon written notification.)
Code (ex: S4321)
Service/VA Service Assignment