AmeriCorps Member Application

Please complete the following application.

Personal Profile

Current Address

All information will be sent to this address, unless you notify us of a change.
Are you moving within the next 6 months?

Permanent Address

Please give the name and address of a person through whom you can always be reached.

Member Eligibility

AmeriCorps members must be a United states citizen, U.S. National or Lawful Permanent Resident. Are you a United States Citizen, national, or lawful permanent resident alien?
If you are a lawful permanent resident alien and you received your card before January 1987, what is your Registration number?


Do you have a particular Reservation location (county) in which you are interested serving?
If yes, please provide the county within the Reservation In which you would prefer To serve:
Please indicate your date of availability to begin work.