2025-2026 AmeriCorps 4-H Host Site Application
Applicant and Organization Information
5 Points
Name of Individual Submitting the Application
*
First Name
Last Name
Email for Individual Submitting the Application
*
example@example.com
Organization Name
*
Organizational Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Will you be serving as the Host Site Supervisor?
*
Yes
No
If you (submitter) will not be serving as the host site supervisor, please indicate the the Host Site Supervisor Name, Title, Phone Number and Email Address.
Do you have authority to commit/receive funds?
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Yes
No
If you (submitter) do not have authority to commit/receive funds, please indicate the Authorized Contact's Name, Title, Phone Number and Email Address.
Have you hosted AmeriCorps 4-H members in previous years?
*
Yes
No
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Organizational Overview
10 Points
Provide a clear and concise description of your organization. Detail your organization's mission and the major programs and services it currently offers to its community.
*
0/2500
Link to Organization Website
*
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AmeriCorps 4-H Project Narrative
100 Points Total
Why do you want to host an AmeriCorps member(s) and how will the AmeriCorps member(s) serve in your organization to increase community capacity to provide youth with positive youth development experiences? Review local data and demonstrate how your local initiative will address the community's need. Please cite the data source (I.e Iowa Youth Survey, Council, Health Assessment, Delinquency Data, etc.) Provide a summary of the proposed AmeriCorps member(s) project, including target numbers of unduplicated youth completing 6 or more hours of programs.
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0/2500
Projected number of youth completing at least 30 minutes of programming or more throughout the service year.
*
Whole Numbers Only
Projected number of youth completing at least 6 hours of programming or more throughout the service year. These youth will receive a survey after 3 hours of programming and then again at 6 hours of programming (if they are 4th-12th grades)
*
Whole Numbers Only
Will you be utilizing the predefined Standard Term Position or requesting a Project Specific Term Type? Please review the RFP to determine if a Standard Term or Project Specific Term is best for your organization.
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Member Position Profiles
Project Specific Term
I am requesting both Position Profile and Project Specific Members
Total proposed Standard Term AmeriCorps 4-H Member(s) for your Organization.
Number of Member(s) Requested
Full Time Positive Youth Development & Outreach Specialist 1700 hours, must discuss first with program staff to check availability.
Full Time Environmental Education & Outreach Specialist1700 hours, must discuss first with program staff to check for availability
Three Quarter Time Positive Youth Development & Outreach Specialist1200 hours
Three Quarter Time Environmental Education & Outreach Specialist1200 hours
Half Time (12 Month) Positive Youth Development & Outreach Coordinator 900 hours
Half Time (12 Month) Environmental Education & Outreach Coordinator900 hours
Half Time (7 Month) Positive Youth Development Educator900 hours
Half Time (7 Month) Environmental Educator900 hours
Quarter Time Summer Positive Youth Development Instructor450 hours
Quarter Time Summer Environmental Education Instructor450 hours
Total proposed Standard Term AmeriCorps 4-H Member(s) for your Organization.
Number of Member(s) Requested
Youth Mental Health Corps Member
0
1
2
3
Total proposed Project Specific AmeriCorps Member(s) for your Organization.
Project Title
Member Slot Type
Total Number of Members Proposed
Project 1
Full Time
Three Quarter Time
Half Time
Reduced Half Time
Quarter Time
Minimum Time
Project 2
Full Time
Three Quarter Time
Half Time
Reduced Half Time
Quarter Time
Minimum Time
Project 3
Full Time
Three Quarter Time
Half Time
Reduced Half Time
Quarter Time
Minimum Time
Project 4
Full Time
Three Quarter Time
Half Time
Reduced Half Time
Quarter Time
Minimum Time
Position Description - Identify 6-8 specific and timely service activities that each type of member you've requested will be completing through their service term. Do not use the word "assist", as it implies unskilled tasks and the member should take on challenging or skill-based duties at the host site with opportunities for leadership.
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AmeriCorps members need support and guidance to be successful. State how your organization has the capacity to support the AmeriCorps member(s) and the proposed initiative. List the support and training you will provide the AmeriCorps member(s). Identify additional development opportunities, support, or benefits you will provide to the AmeriCorps member(s).
*
0/2500
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Recruitment Strategy
10 Points
Please provide a strategy for recruitment of the position. What systems will you employ to recruit quality members? Where do you plan to make the position(s) available? How early do you plan to begin recruitment for the AmeriCorps member position(s)? What challenge(s) do you anticipate facing, and how will you overcome them? Have you had difficulty recruiting adequate applicants before?
*
0/2500
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Previous Successes or Challenges
10 Points
Describe the success of your previous AmeriCorps project(s) and the role of AmeriCorps member(s) in that success. Address challenges encountered in the previous projects and discuss corrective actions or improvement plans. Provide data and examples to support the program success.
0/2500
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Understanding and Submission
In submitting this information to AmeriCorps 4-H, we certify that the information is true and correct to the best of our knowledge.
If selected as a host site, our organization agrees to provide on-site supervision and support for the AmeriCorps member(s), including an on-site orientation and training, and weekly supervisor meetings.
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Yes
No
If selected as a host site, our organization agrees to pay a non-federal cash contribution to help support the AmeriCorps member costs, as well as submit supervisory in-kind match reports twice a month.
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Yes
No
If selected as a host site, our organization agrees to provide adequate space including desk, computer, internet, phone and access to copier.
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Yes
No
If selected as a host site, our organization agrees to participate in AmeriCorps member evaluation, site visits, and other AmeriCorps events deemed appropriate.
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Yes
No
If selected as a host site, our organization agrees to attend Host Site Supervisor Training on September 3, 2025 (Virtual Training) or meet with the Program Director to determine an alternative training appointment.
*
Yes
No
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