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AmeriCorps Service Information
First Name (Required)
Last Name (Required)
Pronouns (Required)
Program (Required)
Host Site (city/town) (Required)
Email (Required)
We won't contact you unless we have questions about your responses.
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Age? (optional)
Is this your first term of service?
Yes
No
Where did you hear about AmeriCorps? (Required)
Why did you decide to join AmeriCorps? (Required)
Which AmeriCorps benefit is most helpful for you and why? (Required)
What do you hope to accomplish during your service? (Required)
Finish the sentence: I serve because... (Required)
If you served before, finish this sentence: AmeriCorps made me... (more empathetic, stronger, etc) (Required)
If you haven't served write N/A
Headshot/Selfie
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Can we contact you in future for information about your service?
Yes
No
