ConnectiCorps Service Member Application 2022-23

ConnectiCorps Service Member Application 2022-23

Thank you for your interest in joining ConnectiCorps! We know that this program will only be as strong as the Service Members we select - a team of individuals who reflect the diversity we see in our communities. We are excited to provide an opportunity for everyone to apply, regardless of ethnicity/race, socioeconomic background, gender identity, sexual orientation, or age (as long as you are 18 before August 1, 2022). Please submit no later than May 31, 2022.
Please note - submitting this application does not guarantee your selection as a ConnectiCorps Service Member. This application will take approximately 30 minutes to complete.

If you have any questions regarding the program, service sites, selection timeline, orientation, etc, please email us at ctcorps@ctnonprofitalliance.org.

Best of luck! We look forward to learning more about you!
Screening Questions

You will not qualify for service with ConnectiCorps if you do not meet the following criteria.
Have you, or will you have, earned a high school diploma, GED, or other equivalent by August 1, 2022? *

Yes No
Have you, or will you, reach the age of 18 by August 1, 2022? *

Yes No
Have you already served 4 terms (part-time or full-time) with AmeriCorps State or National? *

Yes No
Are you a U.S. citizen, U.S. national, or legal permanent resident of the U.S.? (This includes individuals born in the U.S., naturalized U.S. citizens, individuals who have a U.S. citizen parent and qualify under the Child Citizenship Act, and individuals born in Guam, Puerto Rico, American Samoa, U.S. Virgin Islands, and the Commonwealth of the Northern Mariana Islands.) *

Yes No
Please Note: Under AmeriCorps and ConnectiCorps requirements, you will not be eligible for service membership if: you are listed, or are required to be listed, on a sex offender registery; you have been convicted of murder; you refuse to undergo a National Service Criminal History check, or; you make a false statement concerning your criminal history.
General Questions
Full Name *

First Name Last Name
Thanks! Please tell us if there's a different name you want us to use.

First Name Last Name
Current Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email *
example@example.com
Primary Phone Number *

Area Code Phone Number
If you have a resume, please upload it here and skip down to the next required question on the application. If you do not have a resume, or if you are unable to upload your resume, please share your employment, education, volunteer, and training experience in the fields below.
Please upload your resume here

Browse Files

Cancel of
Position Title 1:
Organization or Company Name
Location (City and State)
Start Date

Month Day Year
End Date

Month Day Year
One sentence describing your responsibilities or accomplishments:
Approximately how many hours per week did you dedicate to this position?
Position Title 2:
Organization or Company Name
Location (City and State)
Start Date

Month Day Year
End Date

Month Day Year
One sentence describing your responsibilities or accomplishments:
Approximately how many hours per week did you dedicate to this position?
Education/Training

ConnectiCorps welcomes applicants with a wide variety of educational and training experience. We recommend that you share up to three of your most relevant and substantive educational experiences, which can include an apprenticeship, leadership training, certification, or study abroad program, as well as your highest level of completed education. Please begin with your most recent training/education.
Highest level of education attained prior to August 1, 2022

High School Diploma/GED/Equivalent Associate's Degree Undergraduate Degree Graduate Degree
Institution/School Name
Location (City and State)
Program of Study/Major (if applicable)
Year of Completion
Title of Training or Certification Completed
Location (City and State)
Year of Completion
Title of Apprenticeship Completed
Organization or Company Name
Location (City and State)
Year of Completion
Please share any additional educational or training experience in the space below (include institution or organization name, location, year of completion, and program of study, if applicable).
Have you previously served as an AmeriCorps Member? *

Yes No
If yes, please include the program and service term here.
References

Please provide up to 3 references. We would prefer 2 of these references to be people you've worked with in some way (paid work, volunteer service, etc.). One reference should be from a supervisor or teacher.
Reference #1 Full Name *

First Name Last Name
Relationship to Applicant (How do they know you?) *
Phone Number *

Area Code Phone Number
Email *
example@example.com
Reference #2 Full Name *

First Name Last Name
Relationship to Applicant (How do they know you?) *
Phone Number *

Area Code Phone Number
Email *
example@example.com
Reference #3 Full Name *

First Name Last Name
Relationship to Applicant (How do they know you?) *
Phone Number *

Area Code Phone Number
Email *
example@example.com
Additional Questions
What is your first language? *

English Spanish French Arabic Tagalog (including Filipino) Chinese (including Mandarin and Cantonese) Vietnamese Korean Russian
Do you fluently speak any other languages besides English? If so, please check all that apply. *

Spanish French Arabic Tagalog (including Filipino) Chinese (including Mandarin and Cantonese) Vietnamese Korean Russian
Will you own or have access to a vehicle or reliable transportation? (you are not required to have access to a vehicle, but your answer will ensure that we place you in the most suitable and accessible service location.) *

Yes No I'm not sure yet
How did you hear about this opportunity? *

I have previously served as a ConnectiCorps member News/Media Radio advertising Social Media Friend or family member An organization or affiliation A college or university Indeed Handshake
Our Members will complete either 1,200 hours (30 hours/week average) or 900 hours (20 hours/week average) within their service term. Your service term will be approximately 10 months in duration (September 2022 - July 2023). Please choose your preference for the number of hours you'd be interested in completing. *

1,200 hours 900 hours I don't know yet
Your primary responsibility as a ConnectiCorps Service Member will be to recruit volunteers to safely serve alongside you at the nonprofit you are placed with. You will be provided with PPE during your service term. Are you comfortable serving on site? *

Yes No I'm not sure
The earliest date that I can begin my service is (date must be after September 1, 2022): *

Month Day Year
Short Answers

This section provides you with a space to tell us, in your own words, about your motivations and interest in joining ConnectiCorps. Use this opportunity to share your experience, accomplishments, skills, knowledge and anything else that makes you a unique and well-qualified candidate.
Please share your statement on what community service and involvement means to you. *
As someone who will be serving in your own community, how will you apply your personal experiences to your service? *
Share one example of how you've helped another person, or group of people, and what that experience has taught you. *
Tell us how you think COVID-19 has affected your community. *
Tell us how you think COVID-19 has affected Connecticut's nonprofit organizations. *
Tell us how COVID-19 has affected you, personally. *
Why do you think volunteers are so important to nonprofits?
Optional Demographic Information

All of the questions in this section are optional and will not be considered in the application process. This information is for collection purposes only and will give ConnectiCorps a better understanding of who is applying to our program.

ConnectiCorps respects diversity, and extends service opportunities without regard to age, sex, gender identity, gender expression, race, ethnicity, creed, religion, sexual orientation, national origin, disability/ability, marital status, military or veteran status, or any other legally recognized protected basis under federal, state, or local laws, regulations, or ordinances.
What type of community did you grow up in?

Urban Rural Suburban
What type of community do you live in now?

Urban Rural Suburban
How do you identify your race/ethnicity? (please select all that apply)

Indigenous Arab-American/Middle Eastern Asian Black or African American LatinX Hawaiian/Pacific Islander Two or more races White I do not identify any race or ethnicity
How do you identify your gender?

Male Female Non-Binary
Certification

Please review the following statements and certify their accuracy by checking each box. Please provide an electronic signature at the end.
Section 1: I certify that I am eligible to serve as a ConnectiCorps Service Member for the 2022-23 service term by checking each requirement below. *

I am, or will be, over 18 years old on August 1, 2022. I have achieved my high school diploma, GED, or other equivalent by August 1, 2022. I have not previously served four AmeriCorps State and National terms of service. I am a citizen or permanent resident of the United States.
Section 2: If I am selected as a finalist for a ConnectiCorps Member position, I give ConnectiCorps permission to conduct criminal history background checks in accordance with the Corporation for National and Community Service guidelines. I understand in accordance with AmeriCorps policy, I will not be eligible for service membership if I am listed, or required to be listed, on a sex offender registry, if I have been convicted of murder, if I refuse this background check, or if I provide false information regarding my criminal history. *

I give permission for ConnectiCorps to conduct a criminal history background check
I give ConnectiCorps permission to use any non-identifiable information, in a summary format, that I provide in this application for programming purposes (such as the number of applicants that received an undergraduate degree, or the number of applicants who identify as female). *

I give permission for ConnectiCorps to use non-identifiable information for programming purposes
By checking this box, I certify that the information provided in this application is accurate. I understand that the withholding of any information sought by this application, or the giving of false information on this application, will result in a refusal of selection, or if discovered after I am selected, in disciplinary action up to and including termination. I hereby grant permission to any person, firm, or corporation to release to ConnectiCorps, or its representatives, any and all information regarding my past service, work, education, or employment. I waive any and all claims I might have with respect to the providing of such information. *

I certify that the information in my application is accurate
You're all done! Please submit your application by clicking the button below.
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