New Supervisor information form
The Host Site Organization of this Host Site Agreement agrees that the designated staff member, hereafter, Contractor, will be providing site supervision of AmeriCorps member(s) on behalf of Habitat for Humanity of Iowa AmeriCorps Program. Contractor responsibilities:
provide day-to-day supervision of the AmeriCorps member,
provide the member a safe service environment and the tools/resources needed to perform their service responsibilities,
ensure member performs only service activities outlined in the member service agreement,
report any concerns regarding member performance to the Habitat Iowa AmeriCorps Program Director within 72 hours of awareness,
provide feedback to the member regarding the performance of their AmeriCorps duties,
complete a member mid- and end-term evaluation documenting members’ strengths and areas for improvement,
approve member timesheets within 2 days of the end of the pay period,
track Contractor time dedicated to providing member supervision and provide this record, including the value of time contributed to Habitat Iowa Program Director on a monthly basis (5th of each month), and
comply with other requirements as outlined in the Host Site Agreement
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Email *
First Name (Legal full name) for the background check *
Last Name (Legal full name) for the background check *
What state do you live in?
For those that live other states(NE, IL)  but work in Iowa, there can be slightly different background check steps for AmeriCorps staff.
Affiliate *
Who will you be supervising? *
Shirt Size
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Estimated Start date with Grant/ First day Supervising
Thank you for completing this form!
Next please submit your hourly or yearly pay rate to the Habitat for Humanity of Iowa office. This information is used for matching your time on the grant.
A copy of your responses will be emailed to the address you provided.
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