VISTA AmeriCorps Interest Form | United Way of Kaw Valley

Education Background

What is the highest level of education you have earned?

Institution Name

Dates Attended

Relevant Experience

Company/Organization

City/Town

State/Province

Month/Year-Month Year

Brief description of responsibilities and accomplishments that relate to community service or development.

Company/Organization

City/Town

State/Province

Month/Year - Month/Year

Brief description of responsibilities and accomplishments.

References (please fill out at least 2 references)

Contact Name and Position

Company

Email

Phone

Address

City/Town

State/Province

ZIP/Postal Code

Brief description of your relationship with the reference.

Contact Name and Position

Company/Organization

Email

Phone

Address

City/Town

State/Province

ZIP/Postal Code

Brief description of your relationship with the reference

Contact Name and Position

Company/Organization

Email

Phone

Address

City/Town

State/Province

ZIP/Postal Code

Brief description of your relationship with the reference.

Contact Name and Position

Company

Email

Phone

Address

City/Town

State/Province

ZIP/Postal Code

Brief description of your relationship with the reference.

Contact Name and Position

Company/Organization

Email

Phone

Address

City/Town

State/Province

ZIP/Postal Code

Brief description of your relationship with the reference.

Position Interest

Why do you want to serve with AmericCorps Vista?

Your response here should include personal motivations, experiences and how it aligns with your career goals.

Describe a time you faced a challenge while working on a project. How did you handle it?

Your response here should focus on problem-solving, teamwork and impact.

What skills or experiences do you bring that will be beneficial to your VISTA service?

Your response here should mention specific skills such as project management, communication or fundraising.

Education Background

Relevant Experience

References (please fill out at least 2 references)

Position Interest

Additional Information

Availability

Skills

Interests

Contact