Host Site Application Form

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Host Site Selection Criteria & Expectations

Designate an on-site supervisor and check in with the CI/CF regularly (daily in the beginning of the program, and at least 1-2 times weekly). Supervisors will also sign member time sheets, participate in site visits and complete all necessary program reporting
Attend one host site supervisor training (via conference call) prior to the start of the season.
Clearly identify projects and goals that will fulfill an unmet need, positively affect the community and provide a valuable experience for the AmeriCorps CI/CF member
Help recruit potential members and complete interviews and reference checks of prospective members
Provide the member with a thorough orientation to the community and organization’s philosophy, program, policies, board members and staff
Share success stories and help promote and support the program as appropriate.
Allow member to attend the required program trainings: Orientation in May (all CIs),
Graduation/In-season Training in August (all CI/CFs), Extended Term Graduation in October (Extended
Term Only)
Strictly adhere to MCC AmeriCorps member policies and MCC’s risk management protocols
Complete 2 evaluations (mid and end of season)
Adhere to host site responsibilities and timeline outlined on the next page
Accommodate two hours per week for member to work on MCC paperwork and professional development activities
Provide a computer/internet or fax machine or allocate time during business hours (prior to Mondays at 10:00am) for the CI/CF to go to a public library, school, etc. to submit biweekly paperwork
Selected host sites will be asked to sign a Memorandum of Agreement that identifies the roles and responsibilities of each organization

There is an expectation that the CI/CF is supervised and mentored by MCC AND the host site supervisor. Are you able to meet the supervision requirements outlined above?

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ContactID

OrgID

AmeriCorps Prohibited Activities

AmeriCorps prohibits their members from participating in several activities (see below). Not all prohibited activities are listed. For more information, please contact Angela Davis at adavis@mtcorps.org or (406) 587-4475 x102.

Participating in religious activities or, partisan political activities during designated service hours
Participating in, or endorsing, events or activities that are likely to include advocacy for or against political parties, political platforms, political candidates, proposed legislation, or elected officials
Engaging in any efforts to influence legislation, including state or local ballot initiatives
Administrative work, unless it directly relates to the member’s approved direct service activities
Assignments that displace employees

Host Site Timeline & Responsibilities

I have read and understood the Eligibility and Selection Criteria and have aligned our project with the goals and objectives of the Conservation Intern/Fellow program.

I understand if selected, our organization will sign a Memorandum of Agreement and Site Assurances that details the roles and responsibilities of each entity and commits our organization to the required cash cost share.

Host Site Information

Organization Info

Organization Name

Organization Type

Please Specify

Address

City

State

Postal Code

Member Service Location

This is the address the member(s) will be located.

Address

City

State

Postal Code

Primary Supervisor

First Name

Last Name

Title

Phone

	Yes	No
Is the person completing this application different from the Primary Supervisor (above)?

Person Completing Application (IF DIFFERENT FROM ABOVE)

First Name

Last Name

Title

Phone

Additional partners that may be involved in project(s), support or oversight:

How many Conservation Interns are you interested in hosting? Summer (May 18th – August 19th)

How many Conservation Fellows are you interested in hosting? Extended (May 18th – September 30th)

Housing

Housing Options

Housing Provided

Would you be willing to assist the member in finding affordable housing?

Any other housing notes or concerns?

Cost Share

The required cost share is $9500 (May-Sept) and/or $6000 (May-August) per Conservation Intern/Fellow.

Position Details

What professional development opportunities will you offer to your member(s)? (certifications, trainings, conferences, job shadowing, etc.)

Describe the conservation need the Conservation Intern/Fellows(s) will be addressing.

What will the member’s primary duties be and what projects will they be assisting your organization with?

MCC staff will recruit and conduct the initial screening of applicants to determine interest and qualifications before candidates are referred to the host site for second interviews. Because of this, it is important for MCC to understand the qualities you are looking for in a Conservation Intern.

List the top three specific skills and qualifications that will best suit the project and host site needs. If there are other skills or a need to elaborate, you can do so in the following question

Skill 1

Skill 2

Skill 3

What characteristics would make someone a good fit for your organization?

Is there anything else you would like MCC to take into consideration about your application or additional information you would like to share?

Information for Members

The following information will be shared with applicants that are matched with your organization prior to their second phone interview with you. Please include enough detail for the members to understand what they can expect at your organization.

What is the primary project(s) the member will be working on and what kind of work schedule can the member expect?

What should the member know about your organization and location?

Please share any relevant housing information.

Please list all required gear that the member will need.

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Contact Information