AmeriCorps Project Conserve Member Application 2015 – 2016 Extended Deadline: June 19, 2015
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 AmeriCorps Project Conserve
Member Application 2015 – 2016 Extended Deadline: June 19, 2015 For questions, please contact Amy Stout at (828) 697-5777, ext. 208, projectconserve@carolinamountain.org Your Legal Name: Nickname: Last 4 digits of Social Security Number: Date of Birth: Permanent Mailing Address: Telephone: E-mail: Current Mailing Address (if different from above): Telephone: E-mail:
DIRECTIONS Applications to Host Sites: To be considered for a Project Conserve position, please submit the following documents directly to each host site to which you are applying. All host sites accept electronic (e-mail) or hard copy applications. Host Site contact information can be found under the “How to Apply” link on the APC website. 1. Application Form – An original signature is not required on your applications to the host sites. 2. Short Answers – Short Answer questions are on Page 4 of the application. 3. College Transcript OR proof of high school graduation – An unofficial transcript is acceptable in your applications to the host sites, as long as the transcript is legible and has your name. (Most Project Conserve positions require a college degree. Please see individual service descriptions for specific eligibility requirements.) 4. Resume – Include education, self-employment history, internships/fellowships, full or part-time paid or unpaid work experience, community service and any professional affiliations. Application to Project Conserve Program Director: An additional copy of your application, which includes the documents below, must be submitted to the Project Conserve Program Director. 1. Application Form – If possible, please submit a single pdf or typed word document to simplify processing. 2. Signature Page – This page may be scanned and submitted in a separate document (for email submissions). 3. Short Answers – Short Answer questions are on Page 4 of the application. 4. College Transcript OR proof of high school graduation – An unofficial transcript is permitted at the time of application, as long as it is legible and has your name. An official college transcript must be received within 2 weeks of being offered a position. 5. Resume – Include education, self-employment history, internships/fellowships, full or part-time paid or unpaid work experience, community service experience and any professional affiliations. 6. A Copy of your Birth Certificate OR valid U.S. Passport OR Permanent Resident / Alien Registration Card – Please make sure you send only a COPY and that the copy is clear and legible. 7. A Copy of your valid Driver’s License – Please make sure the copy is clear and legible. (Most Project Conserve positions require a Driver’s License. If the position does not require Driver’s License, you may include a copy of another valid photo ID.) 
APPLICATION SUBMISSION INFORMATION
in the service description. To find out where to send your host site applications, please see the Host Site Contact List, which can be found in the Application Instructions under the “How to Apply” link on the Project Conserve website.
of your application to the site.
Program Director Contact Information: Amy Stout projectconserve@carolinamountain.org Carolina Mountain Land Conservancy 847 Case Street, Hendersonville, NC 28792
Associate Asheville GreenWorks AmeriCorps Pollinator Project Outreach Coordinator Carolina Mountain Land Conservancy AmeriCorps Trails Associate Carolina Mountain Land Conservancy AmeriCorps Community Outreach Associate Carolina Mountain Land Conservancy AmeriCorps Stewardship Associate Environmental Quality Institute AmeriCorps Volunteer Coordinator Mills River Partnership AmeriCorps Watershed Outreach Associate Organic Growers School AmeriCorps Program & Outreach Coordinator Polk Co. Office of Agricultural Economic Dev’t AmeriCorps Farm Conservation Education & Outreach Coordinator Polk Co. Office of Agricultural Economic Dev’t AmeriCorps Farm & Consumer Outreach Specialist RiverLink AmeriCorps Assistant Volunteer Coordinator RiverLink AmeriCorps Education Coordinator RiverLink AmeriCorps Watershed Resources Coordinator Southern Appalachian Highlands Conservancy AmeriCorps Land Protection & Education Associate Southern Appalachian Highlands Conservancy AmeriCorps Conservation Education & Volunteer Outreach Associate Southern Appalachian Highlands Conservancy AmeriCorps Stewardship & Volunteer Associate (2)
The policy and intent of CMLC and AmeriCorps Project Conserve are to provide equal employment opportunity to all persons regardless of race, color, religion, national origin, marital status, political affiliation, sexual orientation or gender identity, disability, sex or age, or other status protected by law. Individuals with disabilities are encouraged to apply. AmeriCorps Project Conserve will provide reasonable accommodations to individuals with known mental / physical disabilities.
AmeriCorps Project Conserve is administered by Carolina Mountain Land Conservancy and funded by the Corporation for National and Community Service, the North Carolina Commission on Volunteerism and Community Service in the office of Governor Pat McCrory, and the critical support of our host sites and community partners.
AMERICORPS SERVICEIn the space below, describe any previous AmeriCorps service. In the reflection section, elaborate on why you decided to get involved and how you benefited from the service. PREVIOUS AMERICORPS TERMSHave you previously served in AmeriCorps? NO YESIf “yes,” check all that apply:AmeriCorps *VISTA AmeriCorps *NCCC AmeriCorps *State or National Program DATES OF INVOLVEMENT: From (mo/yr): To (mo/yr): Did you complete your term of service? YES NO Program Name: Location: Contact Person: Phone: Email: Description of Involvement and Reflection on Experience:
COMMUNITY SERVICEIn the space below, describe your involvement in service. How have you reached out to help others, your community, or another community? In the reflection section, elaborate on why you decided to get involved and how you benefited from the service. 1. DATES OF INVOLVEMENT: From (mo/yr): To (mo/yr): Hours / Month: Organization Name: Location: Description of Involvement and Reflection on Experience: 2. DATES OF INVOLVEMENT: From (mo/yr): To (mo/yr): Hours / Month: Organization Name: Location: Description of Involvement and Reflection on Experience:
OPTIONAL INFORMATION The information in the section below is optional (for demographic data only) and will not be used in making selection decisions. Describe your ethnic background, check all that apply: African American Alaskan Native Asian American Hispanic/Latino Middle Eastern Indian Subcontinent Native American Indian Pacific Islander White/Caucasian Other:
SURVEY Please answer all of the following questions: Are you a U.S. citizen, national, or lawful permanent resident of the U.S? Yes No Are you available for the duration of time from 09/01/15 to 07/31/16? Yes No Are you able to perform all functions of the position described? Yes No Yes No Are you willing to submit to a Criminal History Check? Yes No Have you ever been convicted of a felony? Yes No If “YES,” please explain How did you hear about Project Conserve? (i.e. specific website name, from a friend, etc.)
#1 – Name: Address: City/State: Telephone: Email: Relationship: How long has this person known you? #2 – Name: Address: City/State: Telephone: Email: Relationship: How long has this person known you?
SHORT ANSWERSPlease answer the following questions in a separate document and include with your application.
A Point to Ponder… Project Conserve is a program that serves the community and emphasizes building strong partnerships. Please recognize that by applying and accepting a position, you would be willing to serve the FULL eleven months. If you cannot commit to the full term, then please do not apply. Organizations are not able to rehire for the positions until the following year.
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