C.O.R.E. Susquehanna Americorps Application

Please complete the entire application and press SEND IT. If you do not wish to fill out the application online you may copy and paste the application and fill it out by hand. Both pages must be filled out in full; you may include a resumé with attachments and return them to the address listed above.

Daytime Phone:  

Evening Phone:  

Are you a U.S. Citizen or Permanent Resident Alien?   YES NO

Do you have a current driver's license?   YES NO

Do you have personal transportation?   YES NO

Are you interested in part-time or full-time?   Full-Time Part-Time

PERSONAL STATEMENT

Please prepare a personal statement in which you address:

1. Why you wish to join AmeriCorps.
2. What skills or experiences will most help you to contribute to the program.
3. A description of your community service experience. Include social, school, professional and neighborhood projects.

SKILLS

Please indicate areas in which you have had significant training or experience which resulted in working knowledge or a high level of performance.
Check all that apply.

EDUCATION

Beginning with the most recent, please list all schools attended including high school, trade or technical school, college or university.

Previous Experience

Have you previously served with AmeriCorps? YES NO

If so, when? (mm/dd/yyyy)

Criminal Record

Have you been convicted of any criminal offenses? YES NO

If so, are you facing any current charges? YES NO