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NewMexiCorps | Initial Interest Form
Please complete and submit this intake form and a program leader will contact you to discuss the benefits of service. Thank you for your interest in our program!
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Email *
Name (Last, First, Middle initial)  
 *
Email *
Phone Number with Area Code *
Are you a U.S. citizen/legal resident and at least 17 years old? 
 *
Required
Have you ever been convicted/adjudicated of any legal violations other than minor traffic violations?  
 *
Do you understand that participation in the program requires successful completion of a background check? *
Highest Education Level Achieved *
What annual commitment(s) are you interested in?  Check all that apply. *
Required
Program starts 09/01/2025. If selected, what date are you available to begin service? *
MM
/
DD
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YYYY
Which position(s) are you interested in? Check all that apply. *
Required
Which site(s) are you interested in?  Check all that apply. *
Required
Why are you interested in serving as a NewMexiCorps member? *
How did you hear about our program? *
Equal Employment Opportunity
NewMexiCorps and related entities do not discriminate on the basis of race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an employee organization, parental status, military service, or other non-merit factors. For more information re AmeriCorps policies, CLICK HERE
A copy of your responses will be emailed to the address you provided.
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