Certification
By submitting this application electronically, I
certify that all of the statements made in this application
are true, correct, and complete, to the best of my
knowledge, and are made in good faith. Misinformation or
omission of information could result in disqualification or
termination as an AmeriCorps member. If I am selected for
participation in some AmeriCorps programs, including
AmeriCorps NCCC, I may be required to submit to a physical
examination, including drug or alcohol testing. Background
and security checks may also be conducted by some programs.
PRIVACY ACT NOTICE:
The Privacy Act of 1974 (5 U.S.C. § 552a) requires
that the following notice be provided to you: The authority
for collecting information from you in this application is
contained in 42 U.S.C. 12592 and 12615 of the National and
Community Service Act of 1990 as amended, and 42 U.S.C. 4953
of the Domestic Volunteer Service Act of 1973 as amended.
you are advised that submission of the information is
entirely voluntary, but the requested information is
required in order for you to participate in AmeriCorps
programs.
The principal purpose for requesting this personal
information is to process your application for selection
for an AmeriCorps program, and for other general routine
purposes associated with your participation in an
AmeriCorps program. These routine purposes may include
disclosure of the information to federal, state, or local
agencies pursuant to lawfully authorized requests, to
present and former employers, references provided by you in
your application, and educational institutions, for the
purpose of verifying the information provided by you in
your application. In some programs, the information may
also be provided to federal, state, and local law
enforcement agencies to determine the existence of any
prior criminal convictions. The information will not
otherwise be disclosed to entities outside of AmeriCorps
and the Corporation for National and Community Service
without your prior written consent.
|
Education Award Limitations
I understand that I may not receive more than the aggregate value of two full-time education awards and that upon successful completion of the term of service, I will receive only that portion of the education award for which I am eligible, which may be all or a part of an education award, or no education award, pursuant to 45 CFR § 2526.55
|