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Get UCSC Volunteer Waiver and Election of Workers' Compensation Coverage 2017-2024

Loyment duties and without compensation for the benefit of the university) Email copy to the Workers’ Compensation Office in Risk Services at incident@ucsc.edu Name of Volunteer (Please type or print): Home Phone: Home Address: UCSC Sponsored Program/Event/Activity in which volunteer’s services will be provided: Volunteer Appointment Begins on: Ends on: (Month/day/year) (Month/day/year) (Cannot be indefinite) UCSC Department for which Volunteer Services will be provided: Name of Voluntee.

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