Returning Service Site Application for Half-Term Member Positions

This form must be filled out and submitted in one session. We recommend using a downloadable version of the application to draft your responses  if you are unable to complete and submit in one session. Alternatively, a pdf version of this application with your filled-in responses can be downloaded by selecting print (Ctrl+p) and choosing print to adobe pdf (or selecting the adobe PDF option from the list of available printers). 

 

Service Site Information

Lead Applicant Organization

Phone

Site Supervisor (name)
Additional supervisor? NoYes

Site Supervisor (2)
Additional supervisor? NoYes


Site Supervisor (3)
Additional supervisor? NoYes


Site Supervisor (4)


Partnered Service Sites:
Are you re-applying as a partnership of two service sites, with the lead site sharing ¼ - ½ of its member’s service hours? NoYes

Partner Service Site Name

Phone

Partner Site Supervisor (s): Please list all staff at the partner site who will be supervising TerraCorps members

Service Site Eligibility

TerraCorps service sites must meet the following eligibility requirements. Please read the Service Site Application Packet and answer the following questions below.

    Is your organization a non-profit 501(c)3 organization in Massachusetts with land conservation, land access, or sustainable land use as part of its mission or vision statement?

    Is your service area local, regional, state-wide, national, or international? (Note:  the TerraCorps model is designed to support local and regional organizations.)

    Does your organization (or lead organization if sharing a member) have at least one full-time staff member? (Note: necessary for lead service sites)

    Can your organization meet TerraCorps' member supervision requirements?

    Can your organization provide special equipment needed for your TerraCorps members to carry out their service activities?
       Office Space
       Phone
       Voicemail
       Computer
       E-mail Account
       Printer
       Fax Machine

    Does your organization have liability insurance that would cover your TerraCorps member(s) at the service site and in the field?

    Does your organization have the capacity to manage monthly administrative reporting?

    Can your organization cover the following program match per each half-term position?
      1. $4,216 program service fee in cash to TerraCorps
      2. $900+ spent on your members’ service-related travel, equipment, and supplies, not including a computer;
      3. 80-100 hours of staff time per member for in-kind match to the AmeriCorps grant.

    Does your organization offer services without regard to age, religion, disability, political affiliation, veteran status, gender, sexual orientation, race, ethnicity, or national origin?

    Does your organization provide a drug-free workplace?

    Is your organization fully accessible to people with disabilities? Please explain:

Member Request

1)  How many members would you like to have serve at your organization, and in which TerraCorps positions? (You may request more than one member for each position.)

    Regional Conservation Coordinator

    Community Engagement Coordinator



2)  Some service sites share their member’s service with a second service site. Note the percent of each member’s time that will be committed to the lead service site.

%     Regional Conservation Coordinator

%     Community Engagement Coordinator



3)  What other positions, if any, might you want to add in the next 2 years?

    Regional Conservation Coordinator

    Community Engagement Coordinator


Capacity Building Projects

After reading the Service Site Application Packet description and examples of capacity building activities and projects (Appendix A), please answer the following questions:

4)  For each position requested, briefly describe 1 hypothetical service site capacity building project that you intend for your member(s) to carry out. For each project, describe the primary need addressed, goal(s), and partner(s) if applicable. (150 – 200 words)   Note:  We recognize these projects may change based on member interests and other current unknowns.
    If you have additional project ideas that you plan to explore, please list them here.

Service Site and Supervisor Changes

Service Sites and Supervisors have primary responsibility for training the AmeriCorps member(s) and overseeing their service activities, including timekeeping and monthly reporting. (See full description of supervisor responsibilities in our Service Site Application Packet.) After the first 1 – 2 months of their member’s orientation and training, supervisors will plan to meet with their member for at least one hour each week for ongoing guidance and mentoring. Anticipate committing roughly 8% of a full-time equivalent staff position for one full-time member. (Note:  it is critical to report all supervisory staff time as match to the AmeriCorps grant).

5) Please include the following information for any staff newly assigned to be a service site supervisor:
   a.  New Service Site Supervisor Name
   b. Number of hours per week this person works for your organization
   c. Briefly describe the person’s position in your organization/agency (50 – 100 words)
   d. Attach Resume

New Additional Supervisor?NoYes

   a. Service Site Supervisor Name

   b. Number of hours per week this person works for your organization

   c. Briefly describe the person’s position in your organization/agency (50 – 100 words)
   d. Attach Resume

New Additional Supervisor?NoYes


   a. Service Site Supervisor Name

   b. Number of hours per week this person works for your organization

   c. Briefly describe the person’s position in your organization/agency (50 – 100 words)
   d. Attach Resume



6)   If you are planning important changes for hosting members for the second half of the program year (e.g. organizational staffing and member supervisor(s), office location, member training, focus for the member’s activities, etc.), please describe them here:

7)  Service sites are responsible for local recruitment and for applicant interviews and selection. Past experience shows that strong local recruitment efforts often produce better experiences for members and service sites in these ways: housing availability, familiarity with locale, connections to local groups and networks. The TerraCorps program staff will help support local recruitment and manage statewide and national recruitment systems for member applications, interviews, and selection. Describe what your organization will do to assist with local recruitment of member applications.

Thank you for your time!