Host Site Application Form

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Host Site Selection Criteria & Expectations

MCC Statement:

MCC is committed to being welcoming to all and encourage people of all backgrounds to apply. We are working to reduce barriers to participating in our programs. This program is available to all, without regard to race, color, national origin, gender, age, religion, sexual orientation, disability, gender identity or expression, political affiliation, marital or parental status, genetic information, and military service.

Supervisor 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?

Hidden

Contact FA Helper ID

OrgID

Salesforce Static Fields - Update Yearly!

*Ensure that the Position Name formula is updated to the current year in the Salesforce Connector*

CI Position Name

CI Start Date

CI End Date

CI Cost Share

CI AC Term/Type

CI Position Title WB

CI Workbright Onboarding Group

CF Position Name

CF Start Date

CF End Date

CF Position Title WB

CF Cost Share

CF AC Term/Type

CF Workbright Onboarding Group

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 Bryan Wilson at bryan@mtcorps.org or (406) 585-5913.

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
Remote Work/Teleservice -- AmeriCorps members should generally be providing service directly to the people and in the communities where they serve rather than performing service remotely. Therefore, teleservice should be rare, if ever, and involve appropriate documentation, supervision and oversight. Teleservice is appropriate only when the activity can be meaningfully supervised and the hours verified independently and should only be a small portion of the member's total hours.

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 14th – August 13th)

How many Conservation Fellows are you interested in hosting? Extended (May 14th – October 3th)

Housing

What housing options will the member have?

Intern Housing Stipend Options

Fellow Housing Stipend Options

Any other housing notes or concerns?

Cost Share

The required cost share is $14,000 (May-October) and/or $10,500 (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?

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Contact Information