iFoster's PHA TAY AmeriCorps Application 2024

Welcome to PHA TAY AmeriCorps 2024 application. This 10 month internship starts in January 2024 and is for current/former foster youth who reside in LA County only. This internship provides hands-on paid work experience serving Eisner Health patients both virtually on a patient services call center and on site in one of several Eisner clinics across LA County. iFoster is hiring 100 part-time interns.

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Applicant Details

Legal First Name 

Legal Last Name

Name You Prefer to be Called

Date of Birth

Social Security Number

Preferred Pronouns

Please select... She/Her/Hers He/Him/His They/Them/Theirs

Gender You Identify With

Please select... Female Male Non-Binary Other Prefer Not to Answer

Race

Please select... Asian Black or African American Hispanic American Indian Caucasian/White Pacific Islander Other Two or More Prefer Not to Answer

Ethnicity

Please select... Hispanic or Latino Non-Hispanic or Latino Decline to State

County/State or Tribe of Origin (mark n/a if not applicable or you don't know)

Phone

Email

Street Address

Apartment/Unit # (or n/a)

City

State

Zip Code

Are you able to get to an Eisner Health clinic in Downtown LA, Lynwood, Sherman Oaks, or Van Nuys on a regular basis?

Please select... YES, I have transportation Maybe, but I will need some assistance in paying for it NO

Do you speak any languages other than English?  If yes, list all languages you are fluent in and comfortable working with others in.

Resume

Please upload your resume. If you need a template, Click Here

Please upload your resume in PDF or Word. NOT having a resume will NOT exclude you from being hired.

Education: Please complete if you are going to school

Name of School

Major / What You Are Studying

Type of School

High SchoolContinuation HSCollegeTrade / Vocational

Part or Full-Time

Part-TimeFull-Time

Highest Grade Completed To Date

Employment: Please complete if you are currently working

Employer Name

Hours per week you work

Weekly work schedule if you have one (i.e. Mon, Wed, Fri 9am to 5pm)

Have you ever served in any of these AmeriCorps roles? Select all that apply.

TAY AmeriCorpsAmeriCorpsVISTA AmeriCorpsJob CorpsYouth BuildOther Corps ProgramsNone

Needs Assessment

iFoster can often help you with resource needs. Please answer as accurately as possible.

What is your current housing situation?

Please select... Homeless/Couch Surfing I need housing within the next 90 days Stable Housing for at least 3 months Stable Housing for at least 6 months Stable housing for 7+ months

Reliable transportation to and from work?

Please select... Yes I have it No, I do not have this Yes, but I am in jeopardy of losing this in the next three months

Right to work documents (ID, Social Security Card)

Please select... Yes, I have a current valid form of ID and my Social Security Card No

Are you legally authorized to work in the United States

Please select... Yes No Yes, but do not have documents (i.e: Green Card, Work Visa) Unsure, I need support with this question please

The iFoster TAY AmeriCorps Program may require that your are enrolled in SNAP in order to be eligible for the internship. Are you currently enrolled in SNAP(Government Food Assistance Benefits)? 

Please select... Yes No, I need help signing up No, I have applied in the past and was not successful

If you were denied, please let us know why. 

Do you have childcare needs?

Please select... Yes, I have a child and do have appropriate childcare Yes, I have a child and do not have appropriate childcare Yes, but I am in jeopardy of losing this in the next three months Does not apply to me

References

Please provide us with two references who will support your application to be a TAY AmeriCorps member.

Reference #1

First Name 

Last Name

Relationship to You (caregiver, social worker, attorney, mentor, employer, etc)

Phone

Email

Reference #2

First Name 

Last Name

Relationship to You (caregiver, social worker, attorney, mentor, employer, etc)

Phone

Email

Personal Statement

Tell us why you want to be a PHA TAY AmeriCorps member. Why would you like to gain work experience serving patients at Eisner Health in LA County and what do you hope to accomplish through this internship?

Questions? Call/Text (213) 347-5528 or email tayamericorps@ifoster.org