My AmeriCorps - Create Reference Response

Contact My AmeriCorps \| Login
FONT SIZE: Default \| Large

Reference Entry

The form contains the following errors:

First name is a required field.

Last name is a required field.

null is a required field.

Street address is a required field.

City is a required field.

State is a required field.

Zip code is a required field.

Zip extension is a required field.

Title is a required field.

Organization is a required field.

Work phone number is a required field.

The capacity in which you knew the applicant is a required field.

Applicant's level of competency is a required field.

Your overall recommendation of the applicant is a required field.

Your authorization to identify yourself as the source of the reference is a required field.

There has been an internal error with our server. Please contact the help desk at 1-800-942-2677 for assistance.

Please note that you will need to complete and submit this entire form at one time, as you will not be able to save the information and return to it later.

*Applicant Basic Information*

Name: null null		E-mail:
Veteran/Active Duty/Military Family Status:

Current Mailing Address: ,		Permanent Address: ,
Preferred Phone:		Preferred Phone:
Other Phone:		Other Phone:
Preferred Method of Communication:

AmeriCorps engages more than 80,000 Americans a year in results-driven service sponsored by thousands of local and national non-profits, public agencies, faith-based and community organizations. AmeriCorps members help communities meet critical challenges in the areas of education, public safety, the environment, and other human needs. In return, AmeriCorps members may earn an AmeriCorps Education Award that helps pay for college or pay back student loans.

The person named above is applying to be an AmeriCorps member. The applicant has indicated that you would be able to evaluate his or her qualifications and provide us with a candid recommendation.

The success of AmeriCorps largely depends upon an appropriate match between programs and members. Considerable value is placed on personal references during the application review and selection process. Your input is greatly appreciated.

Fields marked with an * are required.

* Title:

* First Name:

Middle Name/Initial:

* Last Name:

* Email:

* Organization:

Is this a foreign (non-US) address? Check here.

* Street address 1:

Street address 2:

* City:

* State:

* Zip code:

* Work Phone:

Home Phone:

*How long have you known the applicant? Years: Months:

*In what capacity have you known applicant?

Job Supervisor	High School Teacher	Clergy
Volunteer Supervisor	College Instructor	Coach
Other(specify):

*In your judgment, how competent is this applicant, as demonstrated by work in the community, in school, on the job, or in a position of responsibility? Please check one.

Outstanding performance

Above average performance

Satisfactory

Below average performance

Unsatisfactory performance

*Overall recommendation

I recommend the applicant for AmeriCorps service.

I have some reservations, but I believe the applicant will succeed in serving with the AmeriCorps.

I do not recommend this applicant for AmeriCorps service.

I AUTHORIZE the program and/or the Corporation for National and Community Service to identify me as the source of this reference and to release a copy of this reference in its entirety upon request to the applicant.

I DO NOT authorize the program and/or the Corporation for National and Community Service to identify me as the source of this reference, nor do I authorize the release of a copy of this reference in its entirety to the applicant.

OMB Number 3045-0054


Contact Us \| Newsletters \| Site Map \| Office of Inspector General \| FirstGov \| Privacy \| Accessibility FOIA \| No Fear Act \| Federal Register Notices Last updated: Monday, March 18, 2024, 03:19 PM Release version: 7.19