SERVICE PROJECT
APPLICATION
JOIN WITH AMERICORPS NCCC
TO GET THINGS DONE IN YOUR COMMUNITY
A meriCorps NCCC (National Civilian Community Corps) is part of AmeriCorps, a network of national and community service programs that engage 75,000 Americans each year in intensive service to meet critical needs in the areas of education, the environment, housing, disaster services, homeland security, and other unmet needs. The NCCC is a team-based, full-time, residential program for men and women between the ages of 18 and 24. Members are based at regional campuses in several states.
Since 1994, more than 14,000 people have served in AmeriCorps NCCC, providing assistance to hundreds of thousands of Americans. Members serve in diverse teams of 8 to 12 individuals and are assigned to projects in their regions.
Corporation for National and Community Service
AmeriCorps NCCC
1201 New York Avenue, NW, 10th Floor
Washington, DC 20525-0001
800-731-0002 (202-606-3472 TTY)
For more than a decade, the Corporation for National and Community Service—through its Senior Corps, AmeriCorps, and Learn and Serve America programs—has mobilized a new generation of engaged citizens. Each year, Americans of all ages and backgrounds serve through these programs to help thousands of national and community nonprofit organizations, faith-based groups, schools, and local agencies meet local needs. National and community service programs work closely with traditional volunteer organizations to broaden, deepen and strengthen the ability of America’s volunteers to contribute not only to their communities, but also to our nation.
Upon request this material will be made in alternative forms for people with disabilities.
Burden Notice: The collection of this information is authorized by the provisions of the National and Community Service Act, as amended by the National and Community Service Trust Act of 1993. This agency informs the potential persons who may respond to the collection of information that such persons are not required to respond to this collection of information unless it displays a currently valid OMB control number. Estimated time to complete this application, including time for reviewing instructions, searching existing data sources, gathering and maintaining data needed, and completing and reviewing the collection of information is 7 hours. If you have any comments regarding this collection of information, send them to: Corporation for National and Community Service, AmeriCorps NCCC, 1201 New York Avenue, NW, Washington DC 20525-0001, phone 800-731-0002.
Privacy Act Notice: The collection of this information is authorized by 42 USC § 12617. The information is intended for use by AmeriCorps NCCC in determining whether or not to support a specific project. Non-public information provided will not be disclosed outside the Corporation for National and Community Service without written permission from the applicant. While providing the information is voluntary, failure to disclose the requested information could affect the applicant's eligibility for project selection.
OMB#3045-0010 • Expires 12/06
AMERICORPS NCCC
The AmeriCorps NCCC (National Civilian Community Corps) is a full-time, residential, national service program that combines the best practices of civilian service with the best aspects of military service. The mission is to strengthen communities and develop leaders through team-based national and community service. Each year, hundreds of young adults serve as NCCC members. Based at campuses in communities in several states, teams take on projects throughout their regions. Members help communities meet needs in the areas of education, the environment, housing, disaster services, homeland security and other unmet needs.
Teams are available to help community and faith-based based organizations, national nonprofits, schools, local municipalities, national and state parks, and Indian tribes. Members tutor students, construct and rehabilitate low-income housing, build and repair trails, work to prevent crime, help citizens prepare for and respond to natural disasters or terrorist acts, manage community volunteers, and address other local needs. Service projects typically last from six to eight weeks. Because members are trained in disaster services and fire fighting, they can be reassigned on short notice to support disaster relief operations.
AMERICORPS NCCC MEMBERS
Members are young men and women, 18 to 24 years old, representing a wide variety of socio-economic, cultural, geographic, and educational backgrounds. They include those with graduate degrees and some who are working on their high school equivalency diplomas.
All members have earned their place on an NCCC team by demonstrating a commitment to serve their community, to develop practical skills, and to make the nation stronger through a year of hard work. The rewards for their service include an increased understanding about how effective and active citizenship can make a positive difference in the lives of others and build stronger communities, technical and interpersonal skills that will serve them well in the future, and an education award that will enable them to continue their education or reduce educational debt.
AMERICORPS NCCC SERVICE PROJECTS
The NCCC accomplishes its mission by working with local community organizations and groups to help them meet needs that they have identified and that would not be fully addressed without additional assistance. Potential sponsors are required to submit an application that outlines project goals and activities. Approved project proposals must meet the following criteria:
Address compelling community needs
Have clearly stated and well planned tasks and objectives
Have demonstrable, measurable goals
Engage all team members in meaningful service throughout the project
Provide opportunities for member growth and development
Involve the community throughout the project
Have a plan for sustainability after the team completes its service
Projects are normally six to eight weeks in duration but will vary depending on the requirements of the project. Projects must be capable of using at least one full team of 8 to 12 members effectively. Transportation and some basic tools are provided by the NCCC; however, project sponsors are required to provide materials, specialized tools, orientation, training, and technical supervision. When teams are based off campus, the project sponsor works with the NCCC to help arrange housing, food, and other logistical needs.
Service projects address community needs in the following program areas:
Disaster Services and Homeland Security: As part of the National Disaster Response Network, NCCC members work hand-in-hand with the Federal Emergency Management Agency, the American Red Cross, and local emergency management agencies to provide assistance when disasters strike. Members are trained and certified in first aid, CPR, damage assessment, family assistance, and fire fighting, and have responded to floods, hurricanes, tornadoes, and forest fires throughout the United States since 1994. Some examples of projects include organizing evacuation drills; pre-stocking community shelter warehouses and food banks; assisting with the implementation of disaster preparedness curricula; establishing databases and community contact phone banks; and distributing educational materials and preparedness kits.
Education and Youth Development: Education projects focus on improving the quality of the educational experience through in-school and out-of-school programming with children and adults. Projects provide direct service to students, parents and families through tutoring, mentoring and providing one-on-one assistance. Teams are available to assist schools and other youth serving groups to prepare students to achieve proficiency on mandated testing, increase awareness of citizenship, promote healthy living and lifestyles, support summer camp programming, and expand the level of support that local organizations can provide to children in a variety of settings.
Environment: In the tradition of the Civilian Conservation Corps of the 1930s, environmental projects help preserve and enhance a community's natural resources. Teams perform a wide range of activities, including conserving and restoring natural habitats in wilderness regions, constructing and rebuilding trails, cleaning up rivers and streams, removing invasive plant species, planting trees, implementing recycling programs, and planting gardens in urban areas.
Housing: Housing rehabilitation and construction projects contribute to the well-being of the community as well as benefit the elderly, the disadvantaged and other economically vulnerable members of society. Often times, the beneficiaries of NCCC housing projects work with the members to build their homes through "sweat equity." Additionally, teams manage volunteer groups from colleges, universities, and civic and faith-based organizations doing the construction.
Other Unmet Needs: A unique and valued characteristic of the NCCC is its unusually flexible responsiveness to immediate needs as identified by communities themselves. The NCCC will consider any proposal from a community that seeks to meet a clearly defined, compelling need. For example, teams work with the elderly in senior centers, assist with programming for the mentally challenged, build wheelchair ramps for people who are physically disabled, and support the services of homeless shelters.
SERVICE PROJECT APPLICATION PROCESS
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The application process for an AmeriCorps NCCC team is a two step
process. The first step is filling out the one page service project
concept form. The second step is submitting the full project
application.
Prerequisite: Service Project Concept Form completed and submitted to the regional Program Office. Upon review, the regional Program Office will notify the organization of its status and the next steps in the application process.
Project applications are available online at www.americorps.gov/nccc or through the regional Program Office.
It is preferred that project applications be typed.
Answer each question as fully as possible. If a question is not relevant write "Not Applicable."
Contact the regional Program Office with any questions.
SUBMIT THE APPLICATION
The project application should be submitted 2 to 4 months prior to the preferred start date of the project.
The sponsor is encouraged to include any supplemental information (brochures, reports, etc.) that will assist in the understanding and evaluation of the project application.
Electronic signatures are acceptable.
The project application may be sent via email, mail or fax to the regional Program Office.
REVIEW THE APPLICATION
The regional Program Office will contact the sponsor to discuss the application and next steps in the process.
Project applications will be retained by the NCCC for three years. The service project application form displays a currently valid O.M.B. Control Number.
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This form will help
AmeriCorps NCCC determine if the organization’s project
concept meets the basic criteria for a service project. Upon
review, the regional Program Office will notify the organization of
its status and the next steps in the application process.
Service Project Concept Form
Organization Name: _________________________________________________________________________
Organization Representative: __________________________________________________________________
Mailing Address: ___________________________________________________________________________
Telephone: _________________ Fax: ______________________ Email: ___________________________
Website: _______________________________
Provide a brief description of your organization's mission.
Provide a brief description about the service activities for which your organization is requesting a NCCC team. Please conclude your statement with the desired outcome expected from the involvement of NCCC.
Provide the address where the service activities will take place if different from the organization address above.
Address: __________________________________________________________________________________
City, State, & Zip Code: _____________________________________________________________________
Check the box for the primary issue area that the project will address.
Education Housing
Environment Disaster Services/Homeland Security
Other Unmet Needs (please specify): _________________________________________________________
How many weeks will it take a team of 8 to 12 members working full-time to complete this project? _________ Proposed Beginning Date: ___________________________ Proposed End Date: ________________________
These dates are Fixed or Flexible
Check the appropriate description of your organization:
Community Non-Profit Local Municipality National or State Park
Faith-Based Indian Tribe Federal Government
School State Government
Other (please specify): ____________________________________________________________________
Have you worked with a NCCC team previously? Yes No
How did you find out about the NCCC?
NCCC Staff Member NCCC Alumni
State CNCS Office Previous NCCC Project Sponsor
State Commission Community Service Office Current NCCC Member
Other (please list): ________________________________________________________________________
__________________________________________________ _______________________________
Signature Date
AmeriCorps NCCC
Service Project Application
Sponsoring Agency/Organization:
__________________________________________________ Co-Sponsoring
Agencies: _________________________________________________________ Sponsor
Representative: _____________________________ Position/Title: _____________________________________ Mailing
Address:
_______________________________________________________________ Office
Telephone: _________________ Fax: _______________
E-mail: _________________ Alternate
Phone Numbers:_____________________
Website:___________________________ How
many weeks will it take a team of 8-12 members working full time to
complete this project? ______ Proposed
Beginning and End Dates: __________________ Dates are Fixed
or Flexible What
is your organization type?
Community Non-Profit * Local Municipality National
or State Park
Faith-Based Indian Tribe Federal Government
School State Government
Other, (please specify)
_________________________________________________________ *
Attach confirmation of non-profit status. Is
your organization currently funded wholly or in part by the
Corporation for National and Community Service? Yes
No
If
yes, is the proposed project funded by an AmeriCorps grant or any
AmeriCorps VISTA resources?
Yes No If
you answered "yes" to either of the above questions,
please provide detailed information concerning the funding source
and utilization of those funds. Could
the proposed project be accomplished with contracted labor?
Yes No
If
yes, does your organization currently have the resources to pay for
contracted labor? Yes No Will
the proposed service replace any of your organization's current or
projected staff? Yes No
Do
you currently or have you ever had a "Fee for Service"
arrangement with a state or local corps program? (Fee for
Service is defined as an agreement in which your organization pays
fees to a service program in exchange for member or team support).
Yes No
What
is your organization's annual budget? (Check only one box)
Less than $150,000 $500,000 - $999,999
$150,000 - $299,999 $1,000,000 - $4,999,999
$300,000 - $499,999 $5,000,000 and above
PROJECT PLAN
1. MISSION AND OBJECTIVES OF YOUR ORGANIZATION
Please limit your response in this section to no more than 250 words.
Describe the overall mission of your agency. This should include a brief history of the organization, an explanation of the organization's mission and how it fulfills this mission through its various programs.
What community needs will be addressed by this project?
Describe how the proposed project will help to meet these needs. What will be the final outcome(s) of services provided?
2. WORK PLAN AND TASKS
D
A detailed work plan is an essential element of successfully
conducting a project. The project must engage all team members in
meaningful service throughout the duration of the project. Members
must be engaged a minimum of 8 hours each day to complete their
service obligation. A final, comprehensive and detailed work plan
will be required before the project is approved and a team
assigned.
The
project is required to provide a site supervisor. The site
supervisor is the individual in charge of daily activities who
serves as a liaison for the team and is available on-site to
respond to team needs.
Provide a work plan including:
The tasks to be accomplished during each week of the service project.
An estimate of the number of members required to complete each task.
A calendar that shows the sequence of activities throughout the duration of the project.
How will the degree of success of the project be measured? Please list direct and demonstrable results of the project. This section should describe not only the system of measurement, but what approximate number must be achieved to describe the project as complete. For instance, miles of fence built, percent increase in reading comprehension tests, number of children immunized, square feet of walls painted, number of volunteers recruited.
Inclement weather can shut down scheduled project activities. The sponsor is required to have a work plan for inclement weather. The inclement weather plan may include service opportunities with other sponsors such as eligible non-profits, schools or local government agencies within a 45-minute drive.
Provide an inclement weather work plan including:
Inclement weather service tasks in the sequence in which they will be addressed.
The address, phone number and site supervisor at the inclement weather project site (if different than regular project site address).
3. COMMUNITY INVOLVEMENT
D
Leveraging and working cooperatively with community volunteers is a
national service priority. Project applications with a strong
community involvement component will be given priority.
How many volunteers support your organization on a weekly basis? How many volunteers are available to the members during the course of the project? Please describe your volunteer outreach efforts.
4. PRIMARY PROJECT SITE
Site mailing address:__________________________________________________________
___________________________________________________________________________
Site Supervisor: _______________________________ Title: _________________________
Cell Phone: ______________________ Site Telephone: _____________________________
Fax: _____________________ E-mail: __________________________________________
Site street address (if different than site mailing address for receiving overnight delivery packages):
___________________________________________________________________________
___________________________________________________________________________
Describe the project area climate, geographical and cultural environment.
Is this an Urban Suburban Rural or Wilderness area?
Please use the following criteria when identifying your geographic area:
Urban projects are in heavily populated areas and cities of 50,000 or more residents.
Suburban communities represent the residential areas right outside of urban areas but do not themselves consist of 50,000 or more residents. For example, if Washington, DC is Urban (population 500,000 residents), then Chantilly, VA (population 40,000 residents) would be Suburban.
Rural projects occur in areas that do not meet the population requirements of urban and suburban areas; usually small towns and communities.
Wilderness projects occur in unpopulated or sparsely populated areas where human contact is very limited.
5. ACCOMMODATIONS AND PROJECT SUPPORT
If the project site is more than a 60-90 minute drive from the NCCC campus, the team will have to be lodged and fed. This is what is called a “spike” project. The inability to provide food and/or meals does not preclude an applicant from receiving a team. However, an application is incomplete and a team cannot be assigned until appropriate housing has been identified. Accommodations should be responsive to the following requirements:
Adequate space for 8-12 members with separate female and male sleeping facilities
Availability of cooking and food storage facilities or meals provided by sponsoring agency
Special dietary arrangements that will accommodate vegetarians (many members do not eat meat or dairy products)
Access to bathroom, shower, and laundry facilities
Safety and security of members, their personal belongings, and equipment
Travel time to work site should be less than one hour
Are there additional cultural, recreational or educational experiences or opportunities that your organization can make available to the members during the course of the service project? If so, please specify.
Please identify available phones, fax, computer or internet access that can be made available to the team for project related purposes.
It is intended that through orientation, training and the project
tasks, members will acquire an in-depth understanding about what
they are doing and why it is important to the community. This
methodology is called service-learning. Project sponsors are
required to work closely with NCCC staff and members in the design,
support and implementation of training, orientation, and other
service-learning opportunities.
6. MEMBER DEVELOPMENT
Pre-Project Training: Describe the necessary pre-project training that the members should receive before arrival at the project.
On-Site Orientation and Training: Provide a comprehensive and detailed development and training plan regarding on-site orientation and training that the members will receive at the project. Orientation and training should include an overview of your organization and the project; a tour of the work site(s) and the community; introductions of the team to the staff of the sponsor organization; any particular issues of safety associated with the project; and the goals and objectives of the project. At least one full day should be dedicated to project orientation.
If members are required to operate dangerous tools and equipment such as skillsaws, chainsaws, augers, forklifts, tractors and other construction machinery to achieve project goals, then training must be provided by the project sponsor. NCCC staff will work with the project sponsor to develop and coordinate special training requirements before team deployment.
Other Service-Learning Opportunities: Describe other learning opportunities related to the project work that could help members enhance their overall knowledge, acquire life skills, and help them acquire an in-depth understanding about what they are doing and why it is important to your community. This could include guest speakers, videos, community events, background documents, discussion of the mission of your organization, information about the larger social issues associated with the project, and new skills the team members will likely develop.
7. PROJECT SUMMARY
Please provide a concise summary of this project in 250 words or less, including the need(s) to be addressed, the tasks to be accomplished, and the expected benefits to the community and to the NCCC members. If a team is assigned to the project, this summary may be used for internal and external purposes such as websites or media materials.
8
The NCCC has safety guidelines that address member safety on the
project site. Copies of these guidelines are available from the
regional campus. The site supervisor should be present on-site with
the team daily during the team’s working hours. The site
supervisor should possess the awareness, experience, and technical
competence to address the project's safety and technical issues.
The Corporation, with the assistance of the U.S. Office of Personnel Management Federal Investigative Services Division, conducts criminal background checks on all NCCC members. Will members be subjected to any additional background checks? Yes No
If yes, please specify what additional background checks are
required, as well as how these requirements will be satisfied.
D
If yes, please provide detailed information concerning identity of
the hazard, and the actions that will be taken prior to project
start up and throughout the project to prevent such exposure from
occurring.
W
If yes, the Material Safety Data Sheets (MSDS) for each chemical
should be available on-site.
Appropriate personal protective equipment (respirators, gloves, goggles, etc.), as well as a properly trained and certified on-site supervisor must be provided by the project sponsor.
Please include an outline of the safety orientation and training you will provide in any instance where a potentially hazardous chemical is used. Other information in this outline should include the name of the site safety supervisor and a statement regarding how the project will meet the Occupational Safety and Health Administration (OSHA) safety standards.
Many cleaning solvents and commonly used construction materials such as adhesives, oil-based paints, brush cleaners, and thinners have hazardous components. Even though the product itself is not considered toxic or hazardous, these components can give off fumes, irritate skin, or cause other uncomfortable conditions. Such products should be described here as well.
A
If yes, please specify and include reference information that will
prepare members to work safely in that environment.
Yes No
Are there any common health conditions that might preclude an NCCC member from fully participating based on project location or project conditions?
List any required or recommended immunizations.
Identify local medical facilities, including address, telephone number, hours of operation, distance from the work site, and team lodging and local emergency response procedures (i.e., 911 response).
Identify any other potential safety considerations associated with the project.
9. TOOLS, EQUIPMENT, AND PERSONAL GEAR
What equipment, tools, and storage facilities will your organization provide?
What equipment and tools are requested from the NCCC to supplement the local supply?
What personal equipment and clothing should the team bring? (For example, cooking gear, sleeping bags or other bedding, inclement weather gear, boots, sun protection, hats and gloves).
Please identify any safety hazards associated with the tools and equipment that will be used on the project and provide details of any safety training that will be provided, and by whom.
The NCCC does not provide chainsaws and large equipment. These types of tools and equipment must be provided by the project sponsor. However, NCCC staff will work with the organization to define minimum standards and expectations.
10. PERMITS
Have work permits and other legal permissions specific to the project been secured?
Yes No
If no, please indicate the date they will be obtained.
IMPORTANT NOTICES
ADDITIONAL PAPERWORK REQUIREMENTS: If the project application is approved and teams perform the service project, the project sponsor will be required to review and provide signatory to two additional documents: the Sponsor Agreement and the Project Completion Report. Sponsoring organizations will also be asked to complete a survey to capture their evaluation of their partnership with the NCCC.
SPONSOR AGREEMENT: Once the project application has been approved, a formal agreement (called a Sponsor Agreement) will be executed between the sponsor organization and the NCCC which will specify the roles, responsibilities, and contributions of both parties. Teams cannot begin work on the project until this agreement is approved by signature by both parties.
PROJECT COMPLETION REPORT: After the project is completed the project sponsor will be asked to review and approve by signature the NCCC project completion report, and return it to the regional Program Office within 5 days of receipt.
SURVEYS: Sponsors who have used the services of teams will be asked to participate in surveys designed to provide the NCCC with feedback that will inform continuous improvement of services.
DISASTER/FIRE RESPONSE: NCCC members and staff are part of the Federal Emergency Management Agency (FEMA) and American Red Cross National Disaster Response Network. In addition, the NCCC assists local, state, and national forest services with wildfire suppression. Potential sponsors should note that in the event of a natural disaster or homeland security crisis, members may be recalled from projects to serve as part of the relief efforts. This could result in a decrease in the number of members assigned to your project, a delay in the deployment of a team, or cancellation of a project.
LIABILITY AND WORKERS' COMPENSATION CLAIMS: The Corporation for National and Community Service (Corporation) is a self-insured federal agency. Consequently, members and federal employees of the NCCC are covered by the provisions of the Federal Tort Claims Act (liability claims) and the Federal Employees Compensation Act (workers' compensation claims) 42 U. S. C. §12620 (b) & (c). Accordingly, the United States Government will assume responsibility for any injuries or property damage caused by the negligence of a member or an employee who was acting within the scope of his/her employment. Similarly, any on-the-job injuries received by an NCCC member or federal employee will be processed by the Corporation and the Department of Labor.
NON-DISCRIMINATION: Under federal law, a project sponsor receiving assistance from the NCCC may not unlawfully discriminate on the basis of race, color, national origin, religion, sex, age, political affiliation, or disability (for otherwise qualified individuals). Corporation for National and Community Service policy also prohibits discrimination on the basis of sexual orientation, marital or parental status, military service, and social affiliations. Project sponsors will be required to sign an assurance of non-discrimination as part of the sponsor agreement.
SERVICE PROJECT LIMITATIONS: In the course of performing a service project, members cannot engage in any work that involves direct fundraising, financial transactions, preparation of a grant application to the Corporation or to any other Federal agency, or any political or inherently religious activities.
SIGNATURE
The service project application must be signed by a representative of the sponsoring organization. An electronic signature will be accepted.
________________________________ ____________________________
Project Sponsor Signature Date
CONTACTING AMERICORPS NCCC
States served by Central Region:
Colorado,
Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri,
Montana, Nebraska, New Mexico, North Dakota, Oklahoma, South
Dakota, Texas, Wisconsin, and Wyoming.
Central Region
Program Office
AmeriCorps NCCC Central Region
Walsh Hall, Room 136
3001 South Federal Blvd.
Denver, CO 80236-2711
Tel: 303-844-7405
Fax: 303-844-7426
E-mail: nccccentral@cns.gov
States served by Northeast Region: Connecticut,
Delaware, Maine, Maryland, Massachusetts, New Hampshire, New
Jersey, New York, Ohio, Pennsylvania, Rhode Island, Virginia,
Vermont, West Virginia, and Washington DC.
Northeast Region
Program Office
AmeriCorps NCCC Northeast Region
VA Medical Center
Building 15, Room 2
Perry Point, MD 21902-0027
Tel: 410-642-2411, ext. 6850
Fax: 410-642-1888
E-mail: ncccnortheast@cns.gov
Western Region
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States served by Western Region: Alaska,
Arizona, California, Hawaii, Idaho, Nevada, Oregon, Utah,
Washington, and the Pacific Territories.
AmeriCorps NCCC Western Region
3427 Laurel Street
McClellan, CA 95652-1014
Tel: 916-640-0310
Fax: 916-640-0318
E-mail: ncccwestern@cns.gov
For projects in Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Puerto Rico and the Virgin Islands, please contact our National Office.
National Office
D
Visit us on the web at
www.americorps.gov/nccc
AmeriCorps NCCC
1201 New York Ave, NW, 10th Floor
Washington, DC 20525-0001
Tel: 800-731-0002
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OMB#3045-0010
● Expires 12/06
File Type | application/msword |
File Title | SERVICE PROJECT APPLICATION |
Author | rshamieh |
Last Modified By | lshelton |
File Modified | 2007-01-31 |
File Created | 2007-01-31 |