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Senior Corps Application

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File Type	application/msword
File Title	Senior Corps Application
Author	Roberts, Angela
Last Modified By	Writer
File Modified	2012-09-03
File Created	2026-07-14
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Overview and Instructions
RSVP Work Plan Development Worksheets
Overview: The summary sheets below, along with the pre-formatted Work Plan Development Worksheets, are optional tools to help you plan placement of your volunteers in the Focus Areas and Performance Measures for the three-year performance period, as specified in the Grant Application Instructions.  By using these templates to pre-plan how your volunteers will be placed in service opportunities and activities, you can plot the scope of your RSVP project, and use each completed sheet to calculate your percentages in each type of Performance Measure. Additionally, the completed Worksheets can be used as reference when you enter your Work Plan data into the eGrants System.


Instructions:
    1) As you complete these worksheets, we encourage you to reference the following resources:  
    • Appendix B: 2013 National Performance Measures Instructions http://www.seniorcorps.gov/pdf/12_0707_appendix_b_performance_measures.pdf
    • National Performance Measure Instruments for RSVP http://www.nationalserviceresources.org/npm/instruments/65 

    2) Use the following definitions when calculating “Total Number of Unduplicated Volunteers” and “Total Number of Volunteers”:
    • Number of Unduplicated Volunteers: This is the proposed number of volunteers who will be performing each service activity.  Each volunteer can only be counted once when assigned to a service activity. The volunteer should be counted in the area where he/she will make the most impact- in terms of the type of service or in terms of the scope of service, such as the most number of hours served.
    • Total Number of Volunteers: The total number of volunteers engaged in the activities, if you were to assign all of them according to each activity, will be entered in this section. In this way, volunteers can be counted more than once- for example, if the same volunteer does two different types of activities such as meal delivery AND companionship, you can account for all assignments in this field.
TIP: When completing these worksheets and entering your volunteer numbers into the eGrants System, remember that the sum of the Number of Unduplicated Volunteers from each work plan must equal the Total Number of Unduplicated Volunteers for the project.    







Volunteer Calculations:
    1) The total number of unduplicated volunteers in your proposed project: ______
        a. Calculate 25% of your total unduplicated volunteers = ________ volunteers
This is the minimum number of unduplicated volunteers to be placed in the Primary Focus Area (see Step 2 below)
        b. Calculate 30% of your total unduplicated volunteers = ________ volunteers
This is the maximum number of unduplicated volunteers to be placed in Community Priorities (see Step 3 below)
        c. Any remaining unduplicated volunteers will be placed in Other Focus Areas (see Step 4 below)
        d. Calculate 10% of your total unduplicated volunteers = _____ volunteers
This is the minimum number of unduplicated volunteers to be assigned to activities with Outcomes (see Step 5 below)

    2) Select the Primary Focus Area 
 Education  	 Healthy Futures  	 Economic Opportunity  	
 Veterans and Military Families 	 Environmental Stewardship	 Disaster Services
Use the relevant Focus Area Worksheet(s) (following on pages 3 to 27) to plan placement of volunteers in performance measures in the Primary Focus Area selected.

    3) Use the Community Priority Worksheet (following on page 31) to plan placement of a maximum of 30% of your unduplicated volunteers.

    4) Use the Focus Area Worksheets (following on pages 3 to 30) as needed to plan placement for the remainder of your unduplicated volunteers. 
Note that the work plans for these volunteer placements will fall under Other Focus Areas (rather than Primary Focus Area) in eGrants.  

    5) Ensure that 10% of your total unduplicated volunteers are in assignments that produce Outcomes.
When you create performance measures, you are required to select “Outputs” but “Outcomes” are only required for 10% of unduplicated volunteers. Review your completed worksheets and select Outcomes for the minimum of 10% of unduplicated volunteers. These Outcomes can be in any Focus Area (Primary or Other).

    6) Once you have completed these worksheets and you are ready to enter Work Plan data into the eGrants System you may want to review the online course “How to Represent Performance Measures in eGrants”, located in the Main Conference Hall section of the Senior Corps Virtual Conference (http://www.nationalserviceresources.org/scvirtualconference).   



Work Plan Development Worksheet		Focus Area: Education			Objective: School Readiness
Community Need:



Output
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
Outcome (optional)
Outcome Instrument
Outcome Target
ED21. Number of children that completed participation in CNCS-supported early childhood education programs

http://www.nationalserviceresources.org/npm/ed21 
Attendance Log; Activity Log; Other
Assisting in Classroom




ED23. Number of children demonstrating gains in school readiness in terms of social and/or emotional development

http://www.nationalserviceresources.org/npm/ed23 
Observation Tool; Teacher Survey; Teacher Pre/Post Survey; Other



Assisting in Classroom – Head Start







Total number of unduplicated volunteers in Output: ______      

Percentage of total unduplicated volunteers in Output: ______
Total number of unduplicated volunteers in Outcome: _______

Percentage of total unduplicated volunteers in Outcome: _______








Community Need:



Output
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
Outcome (optional)
Outcome Instrument
Outcome Target
ED21. Number of children that completed participation in CNCS-supported early childhood education programs

http://www.nationalserviceresources.org/npm/ed21 
Attendance Log; Activity Log; Other
Assisting in Classroom




ED24. Number of children demonstrating gains in school readiness in terms of literacy skills.

http://www.nationalserviceresources.org/npm/ed24 
Standardized Test; Standardized Pre/Post Test; Literacy Assessment Tool; Senior Corps Teacher Survey; Other



Assisting in Classroom – Head Start











Total number of unduplicated volunteers in Output: ______      

Percentage of total unduplicated volunteers in Output: ______
Total number of unduplicated volunteers in Outcome: _______

Percentage of total unduplicated volunteers in Outcome: _______









Community Need:



Output
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
Outcome (optional)
Outcome Instrument
Outcome Target
ED21. Number of children that completed participation in CNCS-supported early childhood education programs

http://www.nationalserviceresources.org/npm/ed21 
Attendance Log; Activity Log; Other
Assisting in Classroom




ED25. Number of children demonstrating gains in school readiness in terms of numeracy (math) skills

http://www.nationalserviceresources.org/npm/ed25 
Standardized Test; Standardized Pre/Post Test; Literacy Assessment Tool; Senior Corps Teacher Survey; Other



Assisting in Classroom – Head Start







Total number of unduplicated volunteers in Output: ______      

Percentage of total unduplicated volunteers in Output: ______
Total number of unduplicated volunteers in Outcome: _______

Percentage of total unduplicated volunteers in Outcome: _______

Community Need:



Output 
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
ED29. Number of children served in child safety, welfare, and health programs 
Other
Comforting Children







Caring for Infants






Helping Young Mothers




Total number of unduplicated volunteers in Output: ______         Percentage of total unduplicated volunteers in Output: ______

Work Plan Development Worksheet		Focus Area: Education		Objective:  K-12 Success
Community Need:



Output
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
Outcome (optional)
Outcome Instrument
Outcome Target
ED2. Number of students that completed participation in CNCS-supported K-12 education Programs

http://www.nationalserviceresources.org/npm/ed2 
Attendance Log; Activity Log; Other
Tutoring—Public Schools




ED5. Number of students with improved academic performance in literacy and/or math

http://www.nationalserviceresources.org/npm/ed5 
Standardized Pre/Post Test; Standardized Test



Tutoring—Faith-Based School









Tutoring - Other







Total number of unduplicated volunteers in Output: ______      

Percentage of total unduplicated volunteers in Output: ______
Total number of unduplicated volunteers in Outcome: _______

Percentage of total unduplicated volunteers in Outcome: _______









Community Need:



Output
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
Outcome (optional)
Outcome Instrument
Outcome Target
ED2. Number of students that completed participation in CNCS-supported K-12 education Programs

http://www.nationalserviceresources.org/npm/ed2 
Attendance Log; Activity Log; Other
Tutoring—Public Schools




ED27. Number of students in grades K-12 that participated in the mentoring or tutoring or other education program, including CNCS-supported service-learning, who demonstrated improved academic engagement


School Records; Teacher Pre/Post Survey; Student Pre/Post Survey



Tutoring—Faith-Based School









Tutoring - Other



























Total number of unduplicated volunteers in Output: ______      

Percentage of total unduplicated volunteers in Output: ______
Total number of unduplicated volunteers in Outcome: _______

Percentage of total unduplicated volunteers in Outcome: _______










Community Need:



Output
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
Outcome (optional)
Outcome Instrument
Outcome Target
ED2. Number of students that completed participation in CNCS-supported K-12 education Programs

http://www.nationalserviceresources.org/npm/ed2 
Attendance Log; Activity Log; Other
Tutoring—Public Schools




ED6. Number of youth that have improved their school attendance over the course of the CNCS-supported program’s involvement with the student

http://www.nationalserviceresources.org/npm/ed6 
Attendance Log; Other



Tutoring—Faith-Based School









Tutoring - Other







Total number of unduplicated volunteers in Output: ______      

Percentage of total unduplicated volunteers in Output: ______
Total number of unduplicated volunteers in Outcome: _______

Percentage of total unduplicated volunteers in Outcome: _______










Community Need:



Output
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
Outcome (optional)
Outcome Instrument
Outcome Target
ED2. Number of students that completed participation in CNCS-supported K-12 education Programs

http://www.nationalserviceresources.org/npm/ed2 
Attendance Log; Activity Log; Other
Tutoring—Public Schools




ED26. Number of students acquiring a GED 
GED Completion Record




Tutoring—Faith-Based School









Tutoring - Other







Total number of unduplicated volunteers in Output: ______      

Percentage of total unduplicated volunteers in Output: ______
Total number of unduplicated volunteers in Outcome: _______

Percentage of total unduplicated volunteers in Outcome: _______










Community Need:



Output
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
Outcome (optional)
Outcome Instrument
Outcome Target
ED4A. Number of disadvantaged youth/mentor matches that were sustained by the CNCS-supported program for at least the required time period

http://www.nationalserviceresources.org/npm/ed4a 
Attendance Log; Activity Log; Other
School-based Mentoring




ED5. Number of students with improved academic performance in literacy and/or math


Standardized Pre/Post Test; Standardized Test



Community-based Mentoring







Total number of unduplicated volunteers in Output: ______      

Percentage of total unduplicated volunteers in Output: ______
Total number of unduplicated volunteers in Outcome: _______

Percentage of total unduplicated volunteers in Outcome: _______








Community Need:



Output
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
Outcome (optional)
Outcome Instrument
Outcome Target
ED4A. Number of disadvantaged youth/mentor matches that were sustained by the CNCS-supported program for at least the required time period

http://www.nationalserviceresources.org/npm/ed4a 
Attendance Log; Activity Log; Other
School-based Mentoring




ED27. Number of students in grades K-12 that participated in the mentoring or tutoring or other education program, including CNCS-supported learning, who demonstrated improved academic engagement
School Records; Teacher Pre/Post Survey; Student Pre/Post Survey



Community-based Mentoring







Total number of unduplicated volunteers in Output: ______      

Percentage of total unduplicated volunteers in Output: ______
Total number of unduplicated volunteers in Outcome: _______

Percentage of total unduplicated volunteers in Outcome: _______









Community Need:



Output
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
Outcome (optional)
Outcome Instrument
Outcome Target
ED4A. Number of disadvantaged youth/mentor matches that were sustained by the CNCS-supported program for at least the required time period

http://www.nationalserviceresources.org/npm/ed4a 
Attendance Log; Activity Log; Other
School-based Mentoring




ED6. Number of youth that have improved their school attendance over the course of the CNCS-supported program’s involvement with the student

http://www.nationalserviceresources.org/npm/ed6 
Attendance Log; Other



Community-based Mentoring







Total number of unduplicated volunteers in Output: ______      

Percentage of total unduplicated volunteers in Output: ______
Total number of unduplicated volunteers in Outcome: _______

Percentage of total unduplicated volunteers in Outcome: _______








Community Need:



Output
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
Outcome (optional)
Outcome Instrument
Outcome Target
ED4A. Number of disadvantaged youth/mentor matches that were sustained by the CNCS-supported program for at least the required time period

http://www.nationalserviceresources.org/npm/ed4a 
Attendance Log; Activity Log; Other
School-based Mentoring 




ED26. Number of students acquiring a GED
GED Completion Record



Community-based Mentoring 







Total number of unduplicated volunteers in Output: ______      

Percentage of total unduplicated volunteers in Output: ______
Total number of unduplicated volunteers in Outcome: _______

Percentage of total unduplicated volunteers in Outcome: _______








Work Plan Development Worksheet		Focus Area: Healthy Futures		Objective: Aging in Place
Community Need:



Output
Output Instrument
Service Activity (each will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output
Target
Outcome (optional)
Outcome Instrument
Outcome Target
H8. Number of homebound OR older adults and individuals with disabilities receiving food, transportation, or other services that allow them to live independently

http://www.nationalserviceresources.org/npm/h8 
Activity Logs; Client Tracking Database; 
Survey; Other

Food Delivery




H9. Number of homebound OR older adults and individuals with disabilities who reported having increased social ties/perceived social support
Survey



Transportation









Companionship









Companionship—Dept. of Veterans Affairs









Providing Financial Literacy or Housing Services









Preventing Elder Abuse







Total number of unduplicated volunteers in Output: ______      

Percentage of total unduplicated volunteers in Output: ______
Total number of unduplicated volunteers in Outcome: _______

Percentage of total unduplicated volunteers in Outcome: _______









Community Need:



Output
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
Outcome (optional)
Outcome Instrument
Outcome Target
H13. Number of caregivers of homebound OR older adults and individuals with disabilities receiving respite services
Activity Log; Client Tracking Database; Survey
Food Delivery




H14. Number of caregivers of homebound OR older adults and individuals with disabilities who reported having increased social ties/perceived social support
http://www.nationalserviceresources.org/npm/h14 
Survey



Transportation









Companionship









Companionship – Dept. of Veterans of Affairs









Preventing Elder Abuse







Total number of unduplicated volunteers in Output: ______      

Percentage of total unduplicated volunteers in Output: ______
Total number of unduplicated volunteers in Outcome: _______

Percentage of total unduplicated volunteers in Outcome: _______










Work Plan Development Worksheet		Focus Area: Healthy Futures		Objective: Obesity and Food
Community Need:



Output
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
Outcome (optional)
Outcome Instrument
Outcome Target
H10. Number of individuals receiving emergency food from food banks, food pantries, or other nonprofit organizations

http://www.nationalserviceresources.org/npm/h10 
Tracking Form; Client Database; Other
Food Distribution




H12. Number of individuals that reported increased food security of themselves and their children (household food security) as a result of CNCS-supported services
Pre/Post Survey; Survey



Food Collection









Food Pantry Support

















Total number of unduplicated volunteers in Output: ______      

Percentage of total unduplicated volunteers in Output: ______
Total number of unduplicated volunteers in Outcome: _______

Percentage of total unduplicated volunteers in Outcome: _______








Community Need:



Output
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
Outcome (optional)
Outcome Instrument
Outcome Target
H11. Number of individuals receiving support, services, education and/or referrals to alleviate long-term hunger

http://www.nationalserviceresources.org/npm/h11 
Attendance Log; Activity Log; Client Tracking Database; Tracking Form/Log; Other
Developing/
Maintaining Community Gardens




H12. Number of individuals that reported increased food security of themselves and their children (household food security) as a result of CNCS-supported services
Pre/Post Survey; Survey



Educating









Providing Services







Total number of unduplicated volunteers in Output: ______      

Percentage of total unduplicated volunteers in Output: ______
Total number of unduplicated volunteers in Outcome: _______

Percentage of total unduplicated volunteers in Outcome: _______










Work Plan Development Worksheet		Focus Area: Healthy Futures 		Objective: Access to Care
Community Need:



Output
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
H2. Number of clients to whom information on health insurance, health care access and health benefits programs is delivered 
Attendance Log; Activity Log; Other
Staffing Hotline






Developing Materials






Distributing Information






Preventing Elder Abuse




Total number of unduplicated volunteers in Output: ______           Percentage of total unduplicated volunteers in Output: ______

Community Need:



Output
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
H4. Number of clients participating in health education programs
Attendance Log; Activity Log; Other
Training






Coaching






Leading or Assisting Bone Builders




Total number of unduplicated volunteers in Output: ______           Percentage of total unduplicated volunteers in Output: ______






Community Need:



Output
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
H7. Number of clients receiving language translation services at clinics and in emergency rooms 
Program Records; Log; Case Management System; Other
Translating




Total number of unduplicated volunteers in Output: ______           Percentage of total unduplicated volunteers in Output: ______

Work Plan Development Worksheet		Focus Area: Economic Opportunity		Objective: Housing
Community Need:



Output
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
Outcome (optional)
Outcome Instrument
Outcome Target
O5. Number of economically disadvantaged individuals, including homeless individuals, receiving housing services

http://www.nationalserviceresources.org/npm/o5 
Inspection Report; Certificate of Occupancy; Activity Log; Client Tracking Database; Attendance Log; Other
Building Homes




O11. Number of economically disadvantaged individuals, including homeless individuals, transitioned into safe, healthy affordable housing.

http://www.nationalserviceresources.org/npm/o11 
Inspection Report; Certificate of Occupancy; Proof of Residence; Other



Repairing Homes









Assisting with Housing Search









Building or Assisting Homes – Habitat for Humanity







Total number of unduplicated volunteers in Output: ______      

Percentage of total unduplicated volunteers in Output: ______
Total number of unduplicated volunteers in Outcome: _______

Percentage of total unduplicated volunteers in Outcome: _______

Work Plan Development Worksheet		Focus Area: Economic Opportunity	 		Objective: Employment
Community Need:



Output
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
Outcome (optional)
Outcome Instrument
Outcome Target
O2. Number of economically disadvantaged individuals receiving job training and other skill development services
Attendance Log; Activity Log; Other
Adult Basic Education




O10. Number of economically disadvantaged individuals placed in jobs 
Acceptance Letter from Employer; Copy of Pay Stub; Program Records; Other



Helping with GED









Adult ESOL/ESL









Other







Total number of unduplicated volunteers in Output: ______      

Percentage of total unduplicated volunteers in Output: ______
Total number of unduplicated volunteers in Outcome: _______

Percentage of total unduplicated volunteers in Outcome: _______

Work Plan Development Worksheet		Focus Area: Economic Opportunity 		Objective: Financial Literacy
Community Need:



Output
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
O1. Number of economically disadvantaged individuals receiving financial literacy services 
Attendance Log; Activity Log; Other
Assisting VITA






Income Tax Tutoring






Preventing Elder Abuse






Providing Financial Literacy Education




Total number of unduplicated volunteers in Output: ______       Percentage of total unduplicated volunteers in Output: ______
	
Work Plan Development Worksheet	Focus Area: Veterans and Military Families   		Objective: Veterans and Military Families Served
Community Need:



Output
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
V1. Number of veterans that received CNCS-supported assistance

http://www.nationalserviceresources.org/npm/v1 
Activity Log; Other
Assistance a DOL VETS Program






Assisting a Dept. of Veterans Affairs Program






Healthy Futures Activity






Economic Opportunity Activity






Food Delivery – VA HBPC






Companionship – VA HBPC






Work with VA VAVS or VAMC






Other




Total number of unduplicated volunteers in Output: ______       Percentage of total unduplicated volunteers in Output: ______

Community Need:



Output
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
V8. Number of veteran’s family members that received CNCS-supported assistance
Activity Log; Attendance Log; Tracking System; Other
Healthy Futures Activity






Economic Opportunity Activity






Assisting a Dept. of Veterans Affairs Program






Other




Total number of unduplicated volunteers in Output: ______       Percentage of total unduplicated volunteers in Output: ______



Community Need:



Output
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
V7. Number of family members of active duty military service members that received CNCS-supported assistance

http://www.nationalserviceresources.org/npm/v7 
Activity Log; Attendance Log; Tracking System; Other
Healthy Futures Activity






Economic Opportunity Activity






National Guard Volunteer Services






Assisting a Dept. of Veterans Affairs Program






Other




Total number of unduplicated volunteers in Output: ______       Percentage of total unduplicated volunteers in Output: ______

Community Need:



Output
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
V9. Number of military service members that received CNCS-supported assistance

http://www.nationalserviceresources.org/npm/v9 
Activity Log; Attendance Log; Tracking System; Other
Healthy Futures Activity






Economic Opportunity Activity






National Guard Volunteer Services






Other




Total number of unduplicated volunteers in Output: ______       Percentage of total unduplicated volunteers in Output: ______




	
Community Need:



Output
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
V3. Number of veterans assisted in pursuing educational opportunities

http://www.nationalserviceresources.org/npm/v3 
Proof of School enrollment; Tracking Systems; Other
Coaching/Counseling






Referring to Services




Total number of unduplicated volunteers in Output: ______       Percentage of total unduplicated volunteers in Output: ______


Work Plan Development Worksheet		Focus Area: Environmental Stewardship		Objective: At-risk Ecosystems
Community Need:



Output
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
EN4. Number of acres of national parks, state parks, city parks, county parks, or other public and tribal lands that are improves

http://www.nationalserviceresources.org/npm/en4 
Activity Logs; Survey; Acknowledgement of Receipt of Services; Tracking Database; Other
Plant establishment or removal






Debris (not basic trash) removal






Land Restoration






Other




Total number of unduplicated volunteers in Output: ______       Percentage of total unduplicated volunteers in Output: ______



Community Need:



Output
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
EN5. Number of miles of trails or waterways (owned/maintained by national, state, county, city or tribal governments) that are improved and/or created

http://www.nationalserviceresources.org/npm/en5 
Activity Logs; Survey; Acknowledgment of Receipt of Services; Other
Creating Trails






Improving Trails






Improving Waterways




Total number of unduplicated volunteers in Output: ______       Percentage of total unduplicated volunteers in Output: ______

Community Need:



Output
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
EN6. Number of tons of materials collected and recycled
Tracking Form; Weight Receipt from Recycling Center or Buyer; Tracking Database; Other
Collecting and Recycling  Materials






Composting






Reusing Materials




Total number of unduplicated volunteers in Output: ______       Percentage of total unduplicated volunteers in Output: ______




Work Plan Development Worksheet		Focus Area: Disaster Services	Objective: Assistance Provided
Community Need:



Output
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
D1. Number of individuals that received CNCS-supported services in disaster preparedness
Call Center Records; Referral Logs; Attendance Sheet; Tracking System; Other
Training






Creating Disaster Kits






Performing Outreach






Other




Total number of unduplicated volunteers in Output: ______       Percentage of total unduplicated volunteers in Output: ______

Community Need:



Output
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
D2. Number of individuals that received CNCS-supported services in disaster response
Call Center Records; Referral Logs; Attendance Sheet; Tracking System; Other
Setting Up Call Centers






Staffing Call Centers






Transporting Victims






Setting Up Shelter






Staffing Shelter






Proving Health/ First Aid Services






Distributing Meals






Other




Total number of unduplicated volunteers in Output: ______       Percentage of total unduplicated volunteers in Output: ______



Community Need:



Output
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
D3. Number of individuals that received CNCS-supported services in disaster recovery
Call Center Records; Referral Logs; Attendance Sheet; Tracking System; Other
Clearing Debris






Renovating Housing






Providing Housing Transition Support






Counseling






Other




Total number of unduplicated volunteers in Output: ______       Percentage of total unduplicated volunteers in Output: ______

Community Need:



Output
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
D4. Number of individuals that received CNCS-supported services in disaster mitigation
Call Center Records; Referral Logs; Attendance Sheet; Tracking System; Other
Fire Mitigation






Tornado/Hurricane Mitigation






Other Disaster Mitigation




Total number of unduplicated volunteers in Output: ______       Percentage of total unduplicated volunteers in Output: ______





Community Need:



Output
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
D6. Number of RSVP volunteer service hours in disaster preparedness, mitigation, response, and recovery.
Attendance Sheet; Tracking System
Assisting with Preparation






Assisting with Mitigation






Responding






Assisting with Recovery




Total number of unduplicated volunteers in Output: ______       Percentage of total unduplicated volunteers in Output: ______















Work Plan Development Worksheet		Focus Area: Capacity Building	 		Objective: Capacity Building and Leverage
Community Need:



Output
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
Outcome (optional)
Outcome Instrument
Outcome Target
G3-3.1. Number of community volunteers recruited by CNCS-supported organizations or National Service Participants
Attendance Sheet; Activity Log; Volunteer Management System; Other
Recruiting Volunteers






G3-3.3. Number of organizations implementing three or more effective volunteer management practices as a result of capacity building services provided by CNCS-supported organizations or national service participants 
Pre/Post Organizational Assessment Tool

Total number of unduplicated volunteers in Output: ______      

Percentage of total unduplicated volunteers in Output: ______
Total number of unduplicated volunteers in Outcome: _______

Percentage of total unduplicated volunteers in Outcome: _______









Community Need:



Output
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
Outcome (optional)
Outcome Instrument
Outcome Target
G3-3.2 Number of community volunteers managed by CNCS-supported organizations or National Service Participants
Attendance Sheet; Activity Log; Volunteer management System; Other
Managing Volunteers




G3-3.3. Number of organizations implementing three or more effective volunteer management practices as a result of capacity building services provided by CNCS-supported organizations or national service participants 
Pre/Post Organizational Assessment Tool



Training Volunteers







Total number of unduplicated volunteers in Output: ______      

Percentage of total unduplicated volunteers in Output: ______
Total number of unduplicated volunteers in Outcome: _______

Percentage of total unduplicated volunteers in Outcome: _______

Community Need:



Output
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
G3-3.16. Dollar value of cash resources leveraged by CNCS-supported organizations or national service participants
Financial Management System; Other
Garnering Donations




Total number of unduplicated volunteers in Output: ______       Percentage of total unduplicated volunteers in Output: ______
		


Community Need:



Output
Output Instrument
Service Activity (each selected will generate a separate work plan)
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Output Target
G3-3.17. Dollar value of in-kind resources leveraged by CNCS-supported organizations or national service participants
Program Records; Financial Management System; Other
Garnering Donations






Supporting Blood Drives






Food Collection






Food Pantry Support






Other




Total number of unduplicated volunteers in Output: ______       Percentage of total unduplicated volunteers in Output: ______














Work Plan Development Worksheet for Community Priorities	Focus Area: Other Community Priorities 		Objective: Other Community Priorities
For all “Community Priorities” measures and activities, there is one standard output: “Grantee met its target for community priority activity (Yes/No).”
Use the worksheets below to develop one work plan that includes all volunteers (no more than 30% of the total unduplicated volunteers) in the Community Priorities Focus Area.
Community Need:



Output
# of Unduplicated Volunteers
# of Total Volunteers
# of Volunteer Stations
Grantee met its target for community priority activity



Total number of unduplicated volunteers in Output: ______       

Percentage of total unduplicated volunteers in Output: ______