Please provide the following information for the university you are currently attending or most recently attended.

Please list your employment history starting with the most recent.

Please list two of your most recent service experiences or volunteer activities.

Your responses to the following questions help us learn more about you and your interest in serving with Project Transformation Oklahoma. Please limit each response to no more than 500 words.

AmeriCorps seeks to involve participants from all economic backgrounds. Please provide your current household information or that of the person claiming you as a dependent.

The AmeriCorps application process requires a criminal history check to ensure community members with whom we work are protected, particularly children, individuals with disabilities, and individuals over 60 years old. We are investigating for past sexual offenses and violent crimes, or crime that would have a direct bearing on your service. This background check will entail our search of the National Sex Offenders Registry and an FBI Criminal History Check, which will require your being fingerprinted prior to pre-service orientation. You will not be permitted to serve or work with children, individuals with disabilities, or individuals over 60 years of age, without supervision until the history check is complete and you are cleared. The review process is not lengthy, and normally is completed within weeks. Answer the following questions fully. Existence of a criminal conviction or juvenile adjudication may or may not, depending on the circumstances, disqualify you from consideration. However, any intentional misrepresentation or omission will disqualify you. Do not include minor traffic violations.

By signing this application, or by submitting it electronically if applying online, 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 requires that the following notice be provided to you: The authority 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 our application for acceptance into 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 the entities outside of AmeriCorps and the Corporation for National and Community Service without your prior written permission.

The Corporation for National and Community Service programs are available to all without regard to race, color, national origin, disability, age, gender, sexual orientation, religion, political affiliation, or other non-merit factors. Anyone believing he or she has been subjected to discrimination on these grounds by the Corporation for National and Community Service, AmeriCorps, or one of its grantees may contact our Office of Civil Rights and Inclusiveness at (202) 606-7503.

In addition to this application, you are required to submit two reference forms. The reference form can be found on the Project Transformation website. It is your responsibility to request the reference forms and ensure that they are received by the Project Transformation office. Your application is not complete until both reference forms are received.