Idaho HealthCorps AmeriCorps Member Application

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Name *

Email *

Phone Number *

What state do you live in at this time? *

What program or site are you applying for? *

For example: if you are an ISU member, are you with PT, OT, Dental Hygiene, Nursing, etc? If you are not an ISU member, which non-profit are you applying for? (Astegos, Idaho Food Bank, Genesis, CATCH, etc)

Select which skills apply to you *

Communication

Time Management

Organization

Computer Skills

Customer Service

Problem Solving

Creative Thinking

Other:

Required

What is your shirt size? *

XXL

XXXL

Why do you want to join AmeriCorps? *

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