Sustainability Service Corps - Fellowship Application

Which Term would you like to apply to?

Personal Information

First Name	Last Name
Preferred Name	Pronunciation of Name

Phone(Primary) Example: (444)444-4444	Phone(Secondary) Example: (444)444-4444
Email

Permanent Address

Street	City
State	Zip code

Gender, Ethnicity and Date of Birth

What gender do you identify with? What are your personal pronouns?	What ethnicity(ies) do you identify with / as (can put n/a if you decline to share)? Do you identify as LGBTQIAA+?
Birthdate You must be at least 17 years of age?	Will you be at least 18 years old by the start of the program?

Ability to Travel

Are you able or willing to work on-site?

Are you able or willing to work remotely?

Do you have access to a car that you are willing to use for your commute and/or work purposes?

In order to participate in the Fellowship, you must reside in California within commuting distance to your host site by the start of the program. Whether you are moving from out-of-state, moving within California, or already here, can you commit to our location expectations by the start of the program?

National Service / Military Experience

Are you a veteran?

Have you previously served in a National Service program(AmeriCorps, VISTA, Senior Corps, Learn and Serve)

Which Program?

Other Americorps Program Name

Dates of Service

Did you complete the program?

If no, why?

Criminal History / Agreement

Applicants offered a position with Sustainability Service Corps must complete a California, out-of-state (if applying from outside CA), and federal background check, as well as clear the National Sex Offender Public Register search prior to the start of their first service day. Acceptance into the program is contingent upon results from the checks. Additionally, applicants are not officially AmeriCorps Fellows and cannot begin their service, log hours, or receive their stipend until results from ALL checks have been returned and reviewed. Please indicate that you understand and accept these eligibility requirements. (checkbox)
Candidates are ineligible to serve within the Sustainability Service Corps if they are registered, or required to be registered, as a sex offender; have been convicted of murder; or those who have major felony convictions. Have you ever been convicted of a federal felony in the past?
If yes, please describe the felony as well as any rehabilitation or action taken since

By checking this box, I understand that a state criminal registry check, FBI fingerprint criminal background check and National Sex Offender Public Website check will be conducted by AmeriCorps if I am selected for admission into the program.

Any Felony Convictions?

If yes, please describe

Ability to Work in the United States

Are you a US Citizen, US National, or Permanent Resident? (You must be one of these to apply). As AmeriCorps Members, all Fellows MUST be a citizen, national, or lawful permanent resident alien of the United States. Please indicate that you understand and fulfill these eligibility requirements.

*At this time, we are unable to accept applicants with student visas (such as F1 or F2 student visas, J1 or J2 exchange visitor visas, G series visas, etc.), or those with Deferred Action for Childhood Arrivals (DACA) status. All Fellows offered a position within the program will be required to provide proof of documentation before Orientation.

How did you hear about Sustainability Service Corps?

Marketing Source

Other Marketing Source

Resume and References

Resume

You may attach, or copy & paste in the text box, a resume. (If you are attaching a resume, you may write “See attached" in the text box.)

Upload Resume

Paste Resume

References

Reference #1

First Name

Last Name

Organization

Title

Relationship to Applicant

Best time to contact

Phone

Example: (444)444-4444

Email

Reference #2 (Optional)

First Name

Last Name

Organization

Title

Relationship to Applicant

Best time to contact

Phone

Example: (444)444-4444

Email

Personnel Requirements

Fingerprinting:

The State of California requires that all individuals working with children/youth be fingerprinted and registered with the California Department of Justice. BACR’s policy is to go above and beyond this requirement by making sure all staff and AmeriCorps members are fingerprinted and registered with both the DOJ and the FBI. BACR staff can assist in the fingerprinting process. The time frame for receiving the results varies (1-4 weeks, typically). During this time you may not work alone with children/youth.

Tuberculosis (TB) Test:

The State of California requires that all individuals working with children/youth must get a tuberculin test on an annual basis. Please provide an original copy of the results of your most recent test if you had one within the last year. If you have not had one, BACR staff will assist you in locating a free or low cost clinic to do so. Please keep in mind that TB test results are available 2-3 days after the test is administered.

Required Documentation:

It is necessary in the State of California for all employees to have appropriate employment eligibility and tax information on hand. Furthermore, AmeriCorps members must be U.S. citizens or lawful permanent residents of the United States and have documentation to prove this. This information is forwarded to government agencies for tax and immigration reasons. This information is very important and must be provided to the personnel manager as soon as possible. If this information is not available employment with BACR will be terminated.

Please be prepared to show one of the following in Column A OR one from each of Columns B and C.

A	B	C
Unexpired U.S. passport	Drivers license or ID card issued by a state or outlying posession of the United States, provided it contains a photograph or information such as name, date of birth, sex, height, eye color, and address	Original or certified copy of a birth certificate issued by a state, county, municipal authority, or outlying possessin of the United States bearing an official seal
Certificate of U.S. citizenship (INS Form N-560 or N-561)	U.S. military card	U.S. citizen ID card (INS Form I-197)
Certificate of naturalization (INS form N-550 or N-570)	School ID card with a photograph	ID card for use of resident citizen in the United States (INS From I-179)
Alien registration receipt card with photo (INS Form I-551)

Please Note:

SUSTAINABILITY SERVICE CORPS REQUIRES A FULL-TIME (40 HOURS PER WEEK) COMMITMENT OVER THE TERM OF SERVICE. WE ARE SEEKING CANDIDATES WHO ARE PASSIONATE AND COMMITTED TO SERVING PUBLIC AGENCIES AND COMMUNITIES. IF SELECTED, CAN YOU COMMIT TO SERVING FOR THE FULL SERVICE TERM? (YES/NO)

SUSTAINABILITY SERVICE CORPS OFFERS A MODEST LIVING STIPEND ($31,228 over 11 months) FOR THE TERM OF SERVICE. WE ACKNOWLEDGE THAT LIVING ON SUCH A BUDGET IN CALIFORNIA CAN BE CHALLENGING. AFTER THOROUGHLY CONSIDERING THE COST OF LIVING, TRANSPORTATION, AND OTHER EXPENSES DURING THE SERVICE TERM, DO YOU BELIEVE YOU CAN COMPLETE THE FULL SERVICE TERM WITH LIMITED FINANCIAL HARDSHIP? (YES/NO)

Please explain if you answered "no" to any of the above questions

Bay Area - East	Bay Area - North	Bay Area - South
Bay Area - Peninsula	Bay Area - San Francisco	Central Valley
Greater Los Angeles	San Diego	Central Coast