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Gem State AmeriCorps Host Site Application
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* Indicates required question
Organization's Legal Name
*
Your answer
Is your organization a designated non-profit?
*
Yes
No
Organization Address
*
Your answer
Organization City/ State/ Zip
*
Your answer
How many positions are you interested in?
*
Reminder: AmeriCorps recommends placing at least two members at any one site.
Your answer
What services does your organization provide to community members?
*
Your answer
Does your organization provide any services related to abortions?
*
(abortion services include, but are not limited to: abortions, referrals for abortions, educational information about abortions, etc)
Yes
No
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