Name:  

E-mail:  

Address:   

City:    State:       Zip:  

Phone:   

Birthdate: (mm/dd/yy)          (applicants must be between the ages of 18-25)

Why do you want to serve in the Washington Conservation Corps and what do you expect to gain
from the experience? (1200 Character Limit)

 

Are you legally entitled to work in the United States?  Yes  No

Describe your ability to do the physical demands of this position.  Include a description of your
general health and what activities you do to maintain physical fitness (1200 Character Limit)

Will you need any accommodations to perform WCC job duties? Yes   No

Have you ever been convicted of a felony or sexual misconduct which might unfavorably affect your fitness for this job?  Yes  No

Are you currently employed?  Yes  No  If yes, how many hours/week?

If yes, explain the type of work you have been doing:

What type of position are you applying for?

Crew member      Individual Placement  

What is your job location preference?  Click here to view location descriptions for available positions. (press and hold control key to select up to 3 locations)

  Please choose a location preference 1. Bellingham - NSEA 2. Bellingham - City 3. Skagit - Padilla Bay 4. Skagit - Nature Conservancy 5. Skagit Fisheries Enhancement Group 6. Ellensburg 7. Snohomish - County 8. Stilly/Snohomish Fisheries Enhancement 9. Port Angeles - Olympic National Park 10. Jefferson Conservation District 11. Wenatchee - Spike 12. Chelan/Douglas Land Trust 13. Spokane - Spike 14. King County DNR/Parks 15. Cascade Land Conservancy-Seattle 16. Hood Canal - US Forest Service 17. Hood Canal Salmon EG 18. Tacoma - City 19. Nisqually Wildlife Refuge 20. Yakima Conservation District 21. Olympia - Dept of Ecology 22. Olympia - Nature Conservancy 23. Olympia (city) - Neighborwoods 24. Olympia - Spike (3 Crews)

Education

Graduate/Professional Degree
College Graduate
Some College
Technical School/Apprenticeship
Associate Degree
High School Graduate
GED
Less than High School
If Less than High School, what is the highest grade that you completed?

Post High School Training (College, Business or Technical School, Military, etc. Please include major subjects taken.) - 1200 character limit
 

Work History

(Please indicate your most recent job first)
Employer #1:   Title:

Start Date: Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 08 07 06 05 04 03 02 01 00 99 98 97 96 95 94 93 92 91 90 Ending Date: Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 08 07 06 05 04 03 02 01 00 99 98 97 96 95 94 93 92 91 90   Hrs. Per Week:

Last Wage:   Phone Number:  

Reason for leaving:

Employer #2:   Title:

Start Date: Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 08 07 06 05 04 03 02 01 00 99 98 97 96 95 94 93 92 91 90 Ending Date: Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 08 07 06 05 04 03 02 01 00 99 98 97 96 95 94 93 92 91 90   Hrs. Per Week:

Last Wage:   Phone Number:

Reason for leaving:

Employer #3:   Title:

Start Date: Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 08 07 06 05 04 03 02 01 00 99 98 97 96 95 94 93 92 91 90 Ending Date: Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 08 07 06 05 04 03 02 01 00 99 98 97 96 95 94 93 92 91 90   Hrs. Per Week:

Last Wage:   Phone Number:

Reason for leaving:

Where did you hear about the WCC?

  Newspaper                     Career/Job Fair  

  Word of Mouth                WCC literature (poster, brochure, newsletter)

  AmeriCorps Website       School/University

  WCC Website                 Unemployment office

  Dept. of Personnel          Other:   

Affirmative Action Program

In order to ensure equal employment opportunities, the State of Washington, as part of its Affirmative Action Program, requests your voluntary cooperation by indicating the following. Your answers will be treated as confidential.

Race/Ethnic origin:  

Male  Female Not Specified

Do you have a physical, sensory, or mental condition that substantially limits any of your major life functions, such as working, caring for yourself, walking, doing things with your hands, seeing, hearing, speaking, learning?
Yes  No  Not Specified

If yes, please explain your limitations:

Background Checks

AmeriCorps requires a criminal history background 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. Minor offenses, unless impacting on your assignment, will not bar you from service. This background check will entail a search of the National Sex Offenders Registry. Do you agree to have this background search performed?

Yes  No

Certification

By submitting this application, 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.  I understand that misinformation or omission of information could result in disqualification and/or termination as an AmeriCorps and Washington Conservation Corps member.

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