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Basic
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Motivational Statement

Skills & Experience

Education

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Questionnaire

Demographic Information

References

AmeriCorps gathers demographic information to ensure opportunities to serve are provided for people of all backgrounds. Your responses to the following questions on ethnic origin, racial origin, and socioeconomic background are optional, and if provided, will not affect whether you are accepted into AmeriCorps or any federal benefit you may receive.

 
I prefer not to provide my demographic information.

Which of the following categories best describes
your ethnic origin?  
Hispanic or Latina/o   Not Hispanic or Latina/o

Which of the following categories best describes your racial origin? (Check all that apply)
   American Indian or Alaska Native.
   Asian or Asian American.
   Black or African American.
Native Hawaiian or Other Pacific Islander.
White.
Other

How did you hear about this program? (Check all that apply)
Recruitment brochure College Resource Fair
AmeriCorps online recruitment system Job search Web page
Article (online, newspaper, or magazine) Advertisement in a newspaper/magazine
Guidance counselor/teacher Parent/Relative
Current or Former AmeriCorps Member Friend
TV Commercial Radio Commercial
AmeriCorps recruiter/representative Received information in the mail
AmeriCorps program poster State Service Commission
Twitter Facebook ad or on Facebook in general
Other social media platform. Please specify:
Other:  

Have you previously served with an AmeriCorps program?  
State & National   VISTA   NCCC   None




       

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