Straight Up AmeriCorps Returning Member Application

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This application will be used in conjunction with your original AmeriCorps application materials. The selection process will consider application materials in addition to evaluations of service performance, demonstrated ability to complete program requirements, and ability to provide leadership during a second term. First review of applications for 2008-2009 positions begins: March 21, 2008. Applications received by March 21 will be considered for "early decision." This means a site may interview you and offer you a position before conducting interviews with new applicants. Early decision is not guaranteed for returning members. Applications will continue to be accepted until positions are filled.

Applicant Profile:

Full Name:

Address

Street Address

Address continued

City

State

Zip

Home Phone

Cell Phone

Phone # at current service site

email address

Organizational and Community Involvement:

2007-2008 Service Site:

Site Supervisor Name

Site Supervisor Phone

Duties:

Describe any other work experience since your previous application:

Describe any other formal or informal community service or volunteering you have engaged in since your previous application:

Personal Motivation

What have been your greatest challenges and greatest rewards so far in your 2007/2008 term of AmeriCorps service?

Discuss something you have you learned this year, and how might you apply it next year?

How can you be a positive role model and coach for new members?

Service Site Preference

I would like to be considered for the following sites

You can select more than one site by pressing and holding the control key as you click on your selections

Legal

Existence of a criminal conviction/adjudication may or may not, depending on the circumstances, disqualify you from consideration. However, misrepresentation of that record - lying or not telling the whole truth - will disqualify you. Answer the following questions fully.

Are you now under charges for any offenses or are any civil suits or judgments pending against you? (Include any charges/citations for traffic offenses-excluding parking.)yesno

If you answered yes to the above question, please explain. Include Date, Place, Charge, and Action Taken

Are you now on probation or parole?yesno

If yes, provide the name, address and phone number of the court, probation officer, or parole officer who we can contact to verify the above information.

Thank You!

Thank you for applying for a 2nd term of service with Straight Up AmeriCorps! Once we have reviewed your application, we will contact you to schedule you for an interview with staff. You will need to sign a certification form to certify that all statements made in this application are true, correct, and complete. This can be done during your interview.

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