EQUAL HEART RELIEF AND OPPORTUNITY CORPS

APPLICANT NAME:
AGE:
Equal Heart is recruiting individuals to serve as AmeriCorps Members this summer to engage and distribute free meals to children in low income communities. In return for service, members receive a bi-weekly living allowance and an end-of-term education award.
Requirements: Summer applicants must meet the following minimum criteria:
✔ 17 years old or older by program start date
✔ U.S. Citizen or Permanent Resident
✔ Available all weeks during the summer term
✔ Commitment to serve the community!
Sites are located in eight states and each operate a unique summer program. Please read the fact sheet to determine your preferred placement site. Preference given to applicants local to placement sites.

Select preferred service location:

Arkansas Dream Center in Little Rock, AR
Members serve with the mobile food program to distribute food and engage children at mainly rural sites. Dates: 5/30 - 8/12
Columbus Recreation and Parks Department in Columbus, OH
Members provide physical education, arts, and nutrition programming at summer meal sites. Will also help with outreach and free produce give-away support. Dates: 6/1 - 8/18
Operation Food Search in St. Louis County, MO
Members help distribute food in the community, play with kids, run minicamps, and assist with other tasks to support the summer food program. Dates: 5/22 - 8/12
Second Harvest Food Bank of NE Tennessee in Kingsport, TN
Members fill one of three roles: (1) support back-end food operations, (2) program monitor to ensure all runs smoothly, or (3) summer site leader. Dates: 5/22 - 8/04
United Methodist Church Food Ministry in Latonia, KY
Members engage children at summer food sites throughout the area. Typically members are assigned to one site. Dates: 5/22 - 8/12
Direct-to-Door members support all the aspects of a mobile food program with primary duties focused on distributing food and playing with children. Dates: 5/30 - 8/18
Direct-to-Door in Dallas, TX
Direct-to-Door in Houston, TX
Direct-to-Door in San Antonio, TX
Direct-to-Door in Los Angeles Metro, CA
Direct-to-Door in Denver Metro, CO
All summer members must be available at least 30 hours/week.
Are you available to be scheduled, Monday to Saturday from 7am to 7pm?
Yes No
If no, please indicate your time restrictions:
If you have any trips planned this summer or start school early – please indicate the dates:

Application Process:

Applicants are encouraged to apply early as applications are considered on a rolling basis until all positions are filled. Qualified applicants are screened and interviewed by both Equal Heart and a partner agency before any formal offer is made. To apply, complete this application. You can also download the application as a PDF file and submit offline.

I. Applicant Information

Full Legal Name:
Social Security Number
Address at time of application:
Street Address:
City:
State:
Zip Code:
Phone:
Email Address:
Date of Birth:
Are you a U.S. citizen or a lawful permanent resident?
Yes No
Do you have a Driver’s License?
Yes No
Do you drive your own car?
Yes No
Do you speak Spanish? Yes No
Other Languange

II. Education

Last School Attended
Location
Dates Attended
Currently Enrolled Yes No
Did you graduate? Yes No
Any other schooling you want to disclose?

Please complete the following high school related information:

I possess a high school diploma or have received an equivalency certificate.
School Name / Year
City/State
I do not possess a high school diploma or equivalency certificate. Therefore,
I agree to obtain a high school diploma or its equivalent prior to using the education award and certify that I have not dropped out of K-12 school in order to enroll as an AmeriCorps member.
OR
During my term of service, I agree to pursue a high school diploma or equivalency certificate.

III. Work Experience/Extracurricular Activities

Please list your previous work experience beginning with your most recent position. If you have no work experience, please list extracurricular activities, volunteer work, or other leadership roles you have taken on.
Company /Organization
Title
Worked/Served
From: To:
Duties

Company/Organization
Title
Worked/Served
From: To:
Duties

IV. Essay

Please complete the following essay question. Please use the form field below or attach as a separate document. Your response should be approximately 250-500 words.

Why are you a good fit for AmeriCorps and what do you hope to gain from participating in this AmeriCorps program?

V. Legal Information

Are you currently on probation or been convicted for any criminal offense other than minor traffic violations? * Your certifying signature at the end of this application allows us to run a FBI background check on you prior to service.
Yes No
If Yes, please explain:

VI. Certification

The AmeriCorps application process requires a three-part National Service Criminal History Check. This background check requires a search of the (1) National Sex Offenders Website, (2) a Texas Department of Public Safety check and if pplicable, a state repository check through your current state of residence and (3) a FBI fingerprint background check.
By typing my name in the space below and submitting electronically, I consent to the AmeriCorps program to complete the above-mentioned criminal background checks. I am aware that my identity must be verified with a government issued photo ID. I understand that the results of these checks will be kept confidential, but could affect my eligibility to serve in AmeriCorps with Equal Heart. I am aware that I have the right to review the findings. I certify that all the statements made in this application, including verification of high school diploma or equivalency are true, correct and complete to the best of my knowledge and are made in good faith. Misinformation or omission of information could result in disqualification or termination as an AmeriCorps member. I understand that any offer to serve is contingent upon the results of the required three-part check and proof of my citizenship status and age.
Applicant Signature:
Date:
For parent or guardian of applicants under 18 years of age – By typing my name in the space below and submitting electronically, I certify I have reviewed this application, and I authorize my son/daughter/legal ward to apply and, if selected, to participate in AmeriCorps.
Parent or Guardian Signature:
Relationship:
Date: