2024-2025 AmeriCorps State and National Intent to Apply Form

Please complete this form by August 24th to indicate your organization's intent to apply for AmeriCorps State and National AmeriCorps program. Please note that submission of this form is strongly encouraged, but not required in order to apply.

Name of Organization

Street Address

City

State

Zip Code

Contact Person

Phone Number

Extension (if applicable)

Email Address

Type of grant

Proposed Number of Members

Applicants will not be held to this number, but it is helpful to MSA to have an idea of what organizations may propose. Please note that organizations must apply for a minimum of 10 full-time members (or the equivalent number of part-time members).

Slot Types

full-time, half-time, quarter-time, etc.

Contact Information