Individual Placement Site Partner Application

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Thank you for your interest in partnering with Conservation Corps to host an individual placement! Upon submission of this form, a copy will be emailed to you for your records. Corps staff will receive notification of this request and will reach out to you to discuss project details and next steps toward a fully executed agreement. If you need technical assistance with this form, please contact nicole.zyvoloski@conservationcorps.org
Host Agency and Contact Info






A copy of this completed form will be sent to the email address provided here.





Name, title, email address. Record individuals on separate lines.
Host Agency/Organization Needs


This summary may be used within the recruitment application to summarize each unique service position.


Prioritize three skills or attributes a member will need in order to accomplish the work identified. Please consider the level of training and mentorship you are able to provide.






Map, draft work plan, etc.

Map, draft work plan, etc.
Member Experience




Operations

Members will need their own adequate workspace, equipment and supplies. Site will be responsible for providing:

  • Desk/workspace
  • Computer with standard Windows Office Suite programs and access to online distant learning with Skype.
  • Phone
  • Email access
  • Access to: printer and fax machine

Consider anticipated field gear needs, specialized tools, etc.

Yes
No
Scheduling & Funding





Use this to indicate when you need a response from the Corps about our ability to take on this project.
Specific notes about the funding stream are not required, but it can be helpful to know whether there are mixed grant sources or any kind of cost share supporting the position.







Union Certification

Union certification requirement for MN DNR projects only; all other requesters select "no" and proceed directly to the submit button below.


MN DNR Requester MUST notify their AFSCME Union Representative of this project request.

Certification:
As project host with the MN DNR, I certify that the assignment of Conservation Corps Minnesota members will not result in the displacement of currently employed workers or workers on seasonal layoff or layoff from a substantially equivalent position, including partial displacement such as reduction in hours of non-overtime work, wages, or other employment benefits. Further, MN Conservation Corps members will not perform services or duties that have been performed by or were assigned to any employee who is on strike or is being locked out.

If not completed, see Step 1 on the DNR Intranet page.