Prevention Corps Member Application Form 2026

Welcome to the application for the Prevention Corps program! To complete the application, you will need information about your work history and contact information for at least two references. Before you complete this application, we strongly recommend visiting our website at https://www.preventioncorpsct.org/

Prevention Corps members are part of a statewide effort to end the opioid epidemic, educate on substance use, and support mental health initiatives. Our intensive 10-month, 1200 hour program begins October 1st, 2025 and ends August 31st 2026. Candidates who are selected are placed with a Regional Behavioral Health Action Organization, and dedicate their time and energy to build the capacity of the organizations' prevention initiatives.

To serve, you must be 18 years of age or older; graduated high school or have your G.E.D.; and be a U.S. citizen, U.S. national, or legal permanent resident alien of the United States. There is a federal background check required, and a drug test may be required. Most importantly, you should be excited to engage in your community and make a difference.

We are able to offer a stipend of $20,000 ($17/hr) and an education award of $5,176.50 for your tuition or student loans. This is a full-time, 35 hr / week position. We also offer part-time options of 900 hours, with a stipend of $10,000 and education award of $3,697.50.

Please send your resume and cover letter to us at preventioncorps@catalystct.org.

1. Email

example@example.com

2. Your Full Name

First NameLast Name

3. Your Phone Number

4. Town/City of Residence

5. Do you speak any language other than English?

YesNo

6. If so, what language? (or write N/A)

7. As we are a federally funded program, we have to fulfill certain requirements in order to consider you as a member. Please check all the requirements you are able to fulfill.

18 years of age or olderHold a High School diploma or GEDAble to pass a federal background checkU.S. citizen, U.S. national, or legal permanent resident alien of the United StatesAble to pass a drug test

8. I understand the 1,200-hour term of service averages out to 35 hrs/week with an $20,000 stipend, plus an education award.

Yes, I understand the guidelines of the full-time positionI'm interested in the 900-hour part-time option, with a stipend of $10,000 plus an education awardI'm not sure which term of service will work best for me

9. I understand this service to be completed primarily in-person, Mondays-Fridays, between the hours of 9AM-5PM.

YesNo

10. How did you find us?

How did you find us, if Other?

11. Do you have a driver's license or other State/Federal Identification? (State ID, birth certificate, passport)

YesNo

12. Do you have a car or other reliable and sustainable source of transportation that can be utilized 5 days a week? (Please note: while we can reimburse limited gas mileage, we cannot cover Ubers/Lyfts)

YesNo

13. Are you currently in school? (Undergrad/Graduate/Other)

Yes, Part-TimeYes, Full-TimeNo

14. If yes, what school and what are you studying? (If not, write N/A)

15. Please tell us why you are interested in joining Prevention Corps! What motivated you to pursue this service opportunity address the opioid epidemic, and/or join AmeriCorps? Include any information about past experiences that have led to your interest.

16. Public Health/Social Work/Social Services

17. Communication (Social Media, press releases, creating list serve emails, etc.)

18. Leadership Roles

19. Public Speaking

20. Community Organizing/Volunteering

21. Working in a Team Setting

22. Technology Experience (social media, websites, Zoom, Google Workspace, MailChimp, etc.)

23. Event Planning

24. Writing (professional emails or documents, academic papers, creating work, etc.)

25. What are your other skills and talents?

26. What has been your most impactful work experience so far?

27. Do you understand that this program is a commitment to serve community over 10 months that is accompanied by a modest living stipend and education award, and is not a traditional job?

YesNo

28. Please upload your resume here.

29. Please share two references, their contact information (email and phone number) and your relationship to them. Without this, you will not move forward in the application process.

Prevention Corps Member Application:

Basic Information

Motivational Statement

Skills and Experience

Work Experience