FORMS

Just click on the form title to retrieve your requested form. Notice that some forms may be completed online and emailed directly to the Office of Student Affairs (OSA). Others forms need original signatures and must be printed and then sent to the OSA (SU 201).  The Office FAX number is 760-761-3565.

INCIDENT REPORT FORM

Incident Report with Standards of Conduct Feb 2016  This form must be on file in the Office of Student Affairs in order for action to take place.

Elec. Incident Report with Standards of Conduct (submit electronically) – form must be on file in the Office of Student Affairs in order for action to take place.

GENERAL FORMS

Waiver for Student Representation Fee Payment  (submit hard copy)  –  follow the deadlines posted in the class schedule (Education Code Section 76060.5)

ASG Monetary Request Form  (submit hard copy) – form must be filed with the ASG Financial Liaison or you may take the form to the Office of Student Affairs who will forward it to the ASG Financial Liaison (Associated Student Government Bylaw X).

OSA Equipment Use Request-fa15 (submit hard copy) – form must be on file with the Office Student Affairs two weeks prior to event.

CAMPUS VISITOR FORMS

Vendors Agreement   This form must be on file with the Office of Student Affairs (SU 201) prior to vending date AND LiabilityWaiverIndiv.2016 needs to be completed by individuals.  It is necessary for both forms to be turned in at the same time.  Note change in policy:  All payments must be made by check or credit card.

Outside Vendors Contract  This form must be completed by all Signature Gathers/Petitioners using Palomar College property and be file with the Office of Student Affairs (SU 201) prior to coming onto campus. Plus the Hold Harmless Agreement/Waiver of LiabilityWaiverIndiv.2016 must be completed by individuals.  The forms must be turned in together and prior to the event date.

FOOD BANK

Food Bank Application – 1-16

Print and complete a hard copy Food Bank Application and bring it to the Office of Student Affairs (OSA) SU-201. The application may be used by Palomar College students in an emergency situation requiring a food request. This service is provided as a short term solution to hunger and can be used once a month by currently enrolled students. Significant other/partner/spouse and minor children living with the student applicant are eligible and efforts will be made to include food supplies for those listed on the application.

Prior to bringing the application to the OSA, it must be signed by a Palomar College employee, serving as a referral by having an understanding of the student applicant’s emergency food request. Referrals typically include, but are not limited to, the DRC, Veteran’s office, EOPS, TRIO, LGBTQ faculty advisors, club advisors, faculty members, coaches, and counselors. This service is not intended to replace community social services available to students. More information may be found under the “Student Information” tab on the main page.

In most cases, the application can be dropped off at the OSA and the food request filled by the end of the day. It typically takes 2-3 hours to fulfill the request and students can return to the OSA, prior to leaving campus for the day, for food pickup.

Food Bank Donations may be made directly to the Office of Student Affairs (SU 201). Monetary donations made by check should be made out to Palomar College with a memo notation of Food Bank.

 

EVENT FORMS

Event Agreement This agreement will be between the student organization and group.  Contact the Office of Student Affairs for further explanation. Complete the  W-9 form and attach it to the Agreement Form

Honorarium This agreement will be used for speakers by the organization or group on campus.  Complete the  W-9 form and attach it to the Agreement Form

TRAVEL FORMS

Travel Cover Sheet (reference sheet) Use as a guideline when asking  for permission to travel.

  • Food allowance is $46.00 a day for a 24 hour period or $10 for Breakfast; $15.00 for Lunch; and $25.00 for Dinner. Anything over these amounts will be the responsibility of the travelor.
  • All receipts must be for a single person (i.e. meals, hotels, etc.)
  • Alcohol is not allowed at any time on a College trip.

CONFERENCE ATTENDANCE:  Travel Approval/Reimbursement Claim –This form may be obtained at  and due into the Office of Student Affairs  six (6) weeks before event. The Advisor is responsible for completing all travel paperwork. If the travel is for out-of-state, forms must be completed and into the Office Student Affairs two months prior to the event as this travel must be approved by the Governing Board. The Governing Board meets the second Tuesday of each month.  Board Agenda Item and/or Contract Review & Approval Form Please print on pink paper. Complete form as appropriate for the matter requested, obtain signatures from the appropriate Dean and Vice President, and send, along with a copy of the documents involved, to our office in Room A-3. LiabilityWaiverIndiv.2016 (submit hard copy) – this form is used for all minors traveling and for all out of state/country travel.  Code of Conduct for District Sponsored Events This form is used by students when travel does not include staying overnight.

EVENT FORMS

Use of Palomar College Facilities (submit hard copy) – must be completed to use any room, building, area, lawn, or parking lot at Palomar College. The Use of Palomar College Facilities form  is due into the Office of Student Affairs three weeks before the event  The Liability Waiver  must be completed by requesting use of the campus. See the Activities Coordinator in SU 201 for more information.  Independent Contractor Agreement (submit hard copy)due into the Office of Student Affairs two weeks before the event. This form is to be used for all music or band groups entertaining on campus.   W-9 this form must be turned in with the Events contract.   LiabilityWaiverIndiv.2016 (submit hard copy)  To be completed and submitted by individuals.

 

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