Request edit access
AmeriCorps Member Application
This program is available to all, without regard to race, color, national origin, disability, gender, political affiliation, or religion.
Name: *
Your answer
Preferred Name:
Your answer
Address: *
Your answer
Phone: *
Your answer
Email: *
Your answer
AmeriCorps members are required to be a United States Citizen, U.S. National, or Lawful Permanent Resident to participate in the program. Are you a United States Citizen, National, or Lawful Permanent Resident? *
Have you previously applied with any program at The Service Collaborative of WNY? *
Date available to begin service: *
MM
/
DD
/
YYYY
Have you previously served in AmeriCorps? *
AmeriCorps members are required have a high school degree or equivalent to participate in the program. Select the highest level of education that you have completed: *
What program are you interested in? *
Required
Motivational Statement or Cover Letter: *
We would like to understand more about you and your reasons for applying to AmeriCorps. Take a few minutes and consider those experiences which have made you the person you are today. Please share with us one of these experiences and how it sparked your interest in national service.
Your answer
Resume: *
Please copy and paste your resume here or email a copy of your resume to recruitment@tscwny.org and type EMAILED in the box below.
Your answer
Reference #1: *
Enter the email address of your reference.
Your answer
Reference #2: *
Enter the email address of your reference.
Your answer
Criminal History *
The AmeriCorps application process requires a criminal history check to ensure that community members with whom we work are protected, particularly children, individuals with disabilities, and individuals over 60 years old. We will investigate for past sexual offenses and violent crimes, or crimes that would have a direct bearing on your service. This criminal history check requires The Service Collaborative of WNY to search: (1) the National Sex Offenders Registry, (2) New York State Office of Courts Administration (NYS OCA) and if applicable, from a qualified state-wide criminal history search provider for the State in which you reside permanently and/or at the time of this application process, and (3) FBI criminal history check. You will not be permitted to serve or work with children, individuals with disabilities, or individuals over 60 years of age, without supervision until the history check is complete and you are cleared. The review process is not lengthy. The existence of a criminal conviction or juvenile adjudication may or may not, depending on the circumstances, disqualify you from consideration. However, any intentional misrepresentation or omission will disqualify you. Do not include minor traffic violations.
Required
How did you learn about our program(s)? *
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service