0420-0005 Volunteer Application

OMB Control Number: 0420-0005
Expiration Date: ________

Peace Corps Volunteer Application
Thank you for your interest in serving as a Peace Corps Volunteer. Applying to become a Volunteer should be a
thoughtful process of preparing yourself for a 27-month experience that will be life changing for you, for those
close to you, and for the host communities where you will serve. Please complete all of the sections listed below.
This application must be typed or completed in black ink.
Please complete all of the sections listed below.
Contact and personal information
Information about your education, work experience, and other relevant activities
Two essays
References from your work colleagues and friends
As you complete the application, please keep in mind:
The application can take up to six hours to complete.
In answering a question, provide information that demonstrates you understand what is expected of you during
your Peace Corps service.
Answer all questions thoroughly and accurately and provide up-to-date information throughout the application
process. We may disqualify applicants if we determine that they have provided misleading, inaccurate, or
incomplete information.
The Peace Corps needs Volunteers with specific skills, who are reasonably healthy and can serve where they are
needed. Skills for Peace Corps are acquired through education, professional work experience, volunteer
experience, and/or activities, and hobbies. Complete questions fully to give yourself the best chance for
consideration.
Your essays are used by recruiters in determining the best fit for your Peace Corps experience and, if you are
selected, by the country director in your country of service to help determine how best to support you. Take
adequate time for the essays as they are important to you and to us.
Your health is an important component of Peace Corps service. Thus, in order to serve as a Volunteer, you must
have medical and dental evaluations. You will be required to complete a Health History Form as part of the
application process, but independent of the Peace Corps Volunteer Application. If you are selected for an
interview and nominated for service, you may receive additional instructions regarding your medical and dental
examinations.

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What friends and colleagues say about your qualifications to become a Volunteer is an important part of the
application. You will be asked to provide three references as part of the application.
In order for the Peace Corps to be able to make appropriate selection and placement decisions, it is critical that
applicants provide complete and accurate information throughout the process. You may be disqualified or
separated from Peace Corps service if you provide misleading, inaccurate, or incomplete information during the
application process. Moreover, any intentionally false statement or intentional omission could be subject to fines
and/or imprisonment under 18 U.S.C.§ 1001.
Take adequate time to complete your application. Use this time to reflect on the questions asked. Is Peace Corps
service right for you at this point in your life? If it is, thoughtfully completing this application will help you prepare
for the life-changing experience Peace Corps service can be.
What You’ll Need
Following is a list of information or documents that you may need in order to successfully submit a Peace Corps
Volunteer application:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.

Basic personal information such as contact information
Naturalization number (if applicable)
Updated Resume
Social Security Number
Social Security Number of Spouse (if applicable)
Student Loan or other financial obligation information (if applicable)
Military information (if applicable)
Legal incident information (if applicable)
Employment, volunteer history and practical skills experience information
Educational background information
Three references and corresponding contact information: Work Supervisor, Volunteer
Supervisor, Personal reference (the person cannot be related to you)
12. Two essays demonstrating motivation and cross-cultural experience. Each essay should be
between 250-500 words.
13. Attachments, if applicable (to be included with your submission of the application)
a. Marriage Certificate
b. Notarized letter from spouse (if serving without your spouse)
c. Divorce decree or documentation concerning your legal separation
d. Notarized letter concerning your dependents
e. Notarized letters concerning financial obligations
f. Military Discharge paperwork (DD214)
g. Licenses and Certificates
h. Transcripts
i. Master’s International acceptance letter
If you have additional questions about completing the application, visit
http://www.peacecorps.gov/index.cfm?shell=learn.howvol.stepstoapply.faq

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Expectations
Peace Corps Mission and Core Expectations
Please read the Peace Corps Mission, three goals, and ten Core Expectations below and then acknowledge. These
expectations frame your commitment to the Peace Corps experience and to the application process you are now
beginning.
Your application will not be considered complete until you have accepted the mission and expectations.
The mission of the Peace Corps is to promote world peace and friendship by:
• Helping people of interested countries in meeting their need for trained men and women
• Helping promote a better understanding of Americans on the part of peoples served
• Helping promote a better understanding of other peoples on the part of Americans
In working toward fulfilling the Peace Corps Mission, as a trainee and Volunteer, you are expected to:
1. Prepare your personal and professional life to make a commitment to serve abroad for a full term of 27 months
2. Commit to improving the quality of life of the people with whom you live and work; and, in doing so, share your
skills, adapt them, and learn new skills as needed
3. Serve where the Peace Corps asks you to go, under conditions of hardship, if necessary, and with the flexibility
needed for effective service
4. Recognize that your successful and sustainable development work is based on the local trust and confidence you
build by living in, and respectfully integrating yourself into, your host community and culture
5. Recognize that you are responsible 24 hours a day, 7 days a week for your personal conduct and professional
performance
6. Engage with host country partners in a spirit of cooperation, mutual learning and respect
7. Work within the rules and regulations of the Peace Corps and the local and national laws of the country where
you serve
8. Exercise judgment and personal responsibility to protect your health, safety, and well-being and that of others
9. Recognize that you will be perceived, in your host country and community, as a representative of the people,
cultures, values, and traditions of the United States of America
10. Represent responsibly the people, cultures, values, and traditions of your host country and community to
people in the United States both during and following your service
Core Expectation Acknowledgment
I have read these expectations and understand that I am responsible for meeting these expectations.

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Thank you for your interest in serving as a Peace Corps Volunteer. Should you become a Peace Corps Volunteer,
you will be undertaking an exciting and life-changing experience. To be invited to serve in the Peace Corps, you
must: be a citizen of the United States; be at least 18 years of age; and meet the medical, legal, and security
requirements.
Citizenship

Are you a U.S. citizen (by birth or naturalization), or do you expect to become a naturalized citizen in the next 12
months?
Yes
No
Please provide your place of birth (City, State, Country): ____________________________
If you are a naturalized citizen, please provide your naturalization number (also known as the Alien Registration
Number). For additional information on required legal documentation visit www.peacecorps.gov/legalinfo.
________________________
If in the process of becoming a naturalized citizen in the next 12 months, please provide your estimated date of
naturalization.
_______________________________________
The Peace Corps will not invite you to serve until you have been sworn-in as a naturalized citizen.

Age Requirement
Are you at least 17 years of age? The Peace Corps cannot invite you until you are at least 18 years old.
Yes
No
Peace Corps Health Requirements
Health Requirements: Because of the nature of circumstances in countries and communities where Volunteers
serve and the medical care available in some places, the Peace Corps may not be able to provide medical support
for certain health conditions during the 27 months of service. Other conditions may affect or limit where you can
be placed. If you have concerns and would like to review the Medical Information for Applicants section prior to
completing the application, please visit: www.peacecorps.gov/medical. The conditions listed in this section may
affect your being able to be medically qualified or cause your application to be deferred for a certain period of
time. Other conditions may affect or limit where you can serve. However, each applicant is individually assessed in
connection with determinations on medical clearance.
After you complete this application, you will be sent a series of medical related questions related to medical
clearance.

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Reason for Applying
What most inspired you to apply to the Peace Corps (please select one)?
Corporation for National and Community Service (AmeriCorps)
Please select a specific organization within the Corporation for National and Community Service.
o
o
o
o
o
o

AmeriCorps - America’s Service Commissions
AmeriCorps - City Year
AmeriCorps - National Association of Community Health Centers
AmeriCorps - Teach for America
AmeriCorps - The Corps Network
AmeriCorps - Other

Increase Peace Referral
Partners in Higher Education
Please select a specific Partner in Higher Education.
o
o
o
o
o
o
o
o
o
o

American Indian Higher Education Consortium
The Asian and Pacific Islander American Scholarship Fund
The Council of 1890 Universities
Hispanic Association of Colleges and Universities
Hispanic Scholarship Fund
Phelps Stokes
Thurgood Marshall College Fund (TMCF)
UNCF (The United Negro College Fund)
UNCF SPC – IIPP
Other

Peace Corps Advertisement
Please select the type of Peace Corps advertisement.
o
o
o
o
o
o

Magazine ad
Newspaper ad
Online ad
Public Transportation ad
Radio ad
Television ad

Peace Corps Article
Please select the type of Peace Corps article.
o
o
o

Magazine article
Newspaper article
Online article

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Peace Corps Communication
Please select the type of Peace Corps Communication.
o
o
o
o

Email
Mailing
Social Media (Facebook or Twitter)
Peace Corps Website

Peace Corps Event
Please select the type of Peace Corps event.
o
o

Campus Event
Community Event

Peace Corps Staff member

Returned Peace Corps Volunteer

Other
If “Other,” please indicate what inspired you to apply to the Peace Corps. ______________________________

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Contact Information
Submit Your Resume
Please include a copy of your resume with your application submission.
Contact Information
Please inform the Peace Corps immediately if your contact information has changed.

First name ______________________
Middle name (not initial) ______________________
Last name ______________________
Primary phone ______________________
Work phone ______________________
Other phone ______________________
Permanent email address ______________________
Social Security Number _____-____-_______
The Peace Corps asks you for your SSN because the Peace Corps Act, 22 U.S.C. 2519, requires us to do a background
check on all Volunteers. The SSN is needed for this background check, so providing it to us is mandatory. The Peace
Corps will also use it to ensure that our records are accurate, and for tax and other financial accounting purposes.
Gender
Male
Female
Date of birth (day, month, year) ______________________

Current address
Address line 1 ______________________
Address line 2 ______________________
City ______________________
State/Region/Province ______________________
ZIP/Postal code ______________________
+4 (of ZIP code) ______________________
County (CA residents only) ______________________
Country ______________________

Permanent Address
This should be an address where you can always be reached. This address should be in the U.S.
Address Line 1 ______________________

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Address Line 2 ______________________
City ______________________
State ______________________
ZIP/Postal code ______________________
+4 (of ZIP code) ______________________
County (CA residents only) ______________________
Country ______________________

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Eligibility
Please be aware that if you answer yes to any of the questions in this section, you may be asked to provide
additional information or copies of specific documents. In addition, the Legal Eligibility Office may contact you for
additional information.
Previous Peace Corps History
Have you previously submitted a Peace Corps application?
Yes
No
Please provide date of previous Peace Corps application submitted (mm/yyyy). ______________________
Have you previously participated in Peace Corps pre-service training?

Yes
No

Please provide dates of Peace Corps pre-service training (mm/yyyy). ______________________
Please provide location(s) of previous Peace Corps pre-service training. ______________________
Have you previously served as a Peace Corps Volunteer?

Yes
No
Please provide dates of previous Peace Corps Volunteer service (mm/yyyy). ______________________
Please provide country(s) of previous Peace Corps Volunteer service. ______________________
Have you previously served as a Peace Corps Response Volunteer (formerly known as “Crisis Corps")?

Yes
No
Please provide dates of previous Peace Corps Response service (mm/yyyy). ______________________
Please provide country(s) of previous Peace Corps Response service. ______________________

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Marital Status

The Peace Corps will make efforts to place couples who are married but please be aware that the opportunities to
place couples are more limited than those for individual applicants.
Both you and your spouse must apply at the same time and qualify for assignments in the same country.
Peace Corps’ experience is that couples who have been married for at least a year before they begin service are
better able to adapt to the challenges of the Peace Corps than those newly married.
Select your current marital status
Single (never married)
Married - planning to serve with a spouse
Married – planning to serve without a spouse
Divorced, Legally Separated, and/or Widowed
If you are married, divorced, legally separated and/or widowed, you must complete the corresponding section on
this or following pages.
Married – planning to serve with a spouse
First name of spouse ______________________
Middle name of spouse ______________________
Last name of spouse ______________________
Social Security Number of spouse ______________________
Date of Marriage ______________________
Please note that marriage certificates are required and should be included with your application submission. For
additional information on required legal documentation please visit www.peacecorps.gov/legalinfo. In addition,
each individual's official Peace Corps documents, such as passport, host country work visa, and plane tickets must
all be in the same name. If your marriage plans involve a name change, note that legal procedures to provide
confirmations of name changes can take several weeks. Applicants must provide any name change confirmations
at least 6 months prior to their listed availability date.
Couples serving as Peace Corps Volunteers face some unique challenges. We believe that the best way to help you
prepare for these challenges is to stimulate your thinking concerning various aspects of volunteer service as it
relates to couples. Well-adjusted couples here in the United States, whether married for one year or several
decades, will experience new circumstances while living in a different culture that will require adaptation and
adjustment. As a means of preparing yourselves to serve as Peace Corps Volunteers, we recommend that you
begin to identify and discuss some of the challenges that you may face as a Volunteer couple.
Listed below are some discussion topics that we encourage you to explore together. At the end of this discussion
section, please provide written responses to questions 1 through 5. Although we recognize that each Peace Corps

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experience is unique, these discussion points and subsequent questions address some of the common challenges
that couples serving as Peace Corps Volunteers have identified in the past, and will assist you in your preparation
for service together.

Discussion Points to Explore:
• As a couple, what do you consider as some of the advantages and disadvantages of serving in the Peace Corps at
this time?
• How specifically does each of you deal with stress? How does your spouse's reaction to stress affect your
relationship?
• What support systems do you currently use when you face difficult situations? Whom will you rely upon during
your Peace Corps service for support in addition to your spouse? What coping mechanisms do you plan to employ
to effectively deal with difficult circumstances?
• Identify a challenging situation or event that you have experienced as a couple. How specifically did you handle
that particular situation? What did you learn from that experience?
• If a Volunteer becomes pregnant she might be medically separated from Peace Corps service and sent home.
How does this policy affect your current commitment to serve 27 months in the Peace Corps?
• Undoubtedly, at various stages of Peace Corps service one of you is going to feel more successful than the other in learning the language, initiating projects, assimilating into your community, etc. How have you dealt with
differing levels of success in the past? How have you supported each other when one of you is doing well and the
other is achieving success at a slower pace?
• While each spouse in a couple has his or her own duties as a Volunteer, many Volunteers have found that
married couples are often treated as a single unit in their communities, and may be expected to answer for their
partners in terms of work and social commitments when their spouses are unavailable. While such expectations
and treatment may be completely normal according to the local culture, some Volunteer couples have found such
experiences to be very frustrating at times. Please consider how you may cope with such situations as a Volunteer,
and as a part of a couple.
It is important that you discuss these issues with your spouse and prepare to face the many challenges you will
experience as a couple during Peace Corps service. We ask each of you individually to provide responses to the
following questions.
Please answer the following questions below. Please note that all responses on this page must be 4,000 characters
or less.
1. What do you view as the biggest challenges Peace Corps service will present to you as a couple? Have you
confronted similar challenges in your relationship in the past? If so, how did you overcome them? If not, what
relevant experience have you shared as a couple that will be helpful in meeting these challenges?

2. What are your expectations about serving in the Peace Corps as individuals and as a couple?

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3. Couples must be prepared to live and train in separate communities during the three-month pre-service
training, as couples typically serve in different assignment areas requiring separate trainings in community-based
locations. Additionally, couples must be prepared to endure periods of separation during service due to servicerelated duties, medical issues, etc. Such periods of separation may be difficult. Please describe how you think you
would cope with separation from your spouse during pre-service training, as well as during your service, while
keeping in mind communication options may be extremely limited even within your country of service.

4. Upon completion of pre-service training, couples will be placed in the same community and share a household
together. Typically, such households will have 2-3 small rooms, although some may be limited to one small hut or
living space. Living quarters may feel cramped at times in comparison to housing standards in the United States.
Additionally, many couples will find they share workspace and spend a significant amount of time together while
collaborating on community work activities. At times, it may be difficult for individuals in a couple to find adequate
time, or space, where they can be alone. Please describe how you think you may cope with living in close quarters
with your spouse, and how you may cope with limited options for spending time alone.

5. Many cultures are characterized by clearly defined gender roles that differ from those in the U.S. How do you
believe you will deal with situations that may cause strain on you as an individual, and on your relationship? For
example, the credit for a wife’s work may be attributed to her husband, or a husband may be teased for washing
dishes or clothes, as this is considered “women’s work.”

Married - Planning to serve without a spouse
Name of spouse _____________________
Please note that if you are a married applicant planning to serve without your spouse, you will be required to
provide additional documentation at the time of application.
Your application will be reviewed to determine your suitability for Peace Corps service. This process is designed to
assess an applicant's productive competence, motivation and commitment, emotional maturity, social sensitivity,
and cultural awareness. In this context, we must select those candidates who demonstrate the greatest
probability for success as Peace Corps Volunteers, including fulfilling their commitment to serve the full two years.
Peace Corps service is not for everyone and we have found that those with strong emotional ties to people back
home need to think particularly carefully about a 27-month commitment with the Peace Corps. If you have a close
personal relationship with someone who is not applying to serve in the Peace Corps, we want to make sure that
you have explored the issues below with your spouse and that you are able to make a firm commitment to the
Peace Corps. Before you answer these questions, please discuss them with your spouse.

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You will also be required to submit a notarized letter from your spouse at the time of your application submission.
For additional information on required legal documentation and a sample notarized letter template please visit
www.peacecorps.gov/legalinfo.
1.

How long have you been married? Have you ever been apart during your marriage? If so, how long?
What impact did this have on your marriage?

2.

What impact do you expect a 27-month separation will have on your marriage?

3.

How do you expect to communicate with each other? How often, and by what means? How do you plan
to make important decisions about your future and family while in the Peace Corps?

4.

What are your expectations of seeing each other during the 27 months of Peace Corps service?

Previously Married
If you are divorced or legally separated, you must provide copies of all legal documents related to each divorce or
legal separation (including final divorce decree, settlement agreements, spousal and child support agreements,
etc.) in English, regardless of when or where, including other countries in which the divorce took place. These
documents must be included at the time of application submission. If a former divorced spouse is deceased, it is
not necessary to submit a final divorce decree. For additional information on required legal documentation please
visit www.peacecorps.gov/legalinfo.
Name of spouse ____________________________
Type (Divorce, Legal Separation, Death) ____________________________
Date of divorce, legal separation or death (mm/yyyy) ____________________________

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Additional previous marriage (if applicable) ____________________________
Name of Spouse ____________________________
Type (Divorce, Legal Separation, Death) ____________________________
Date of previous marriage (if applicable) ____________________________

Additional previous marriage (if applicable) ____________________________
Name of Spouse ____________________________
Type (Divorce, Legal Separation, Death) ____________________________
Date of previous marriage (if applicable) ____________________________

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Dependents
Are any persons partially or totally dependent upon you for support, whether or not they are living with you?
Yes
No
Serving as a Peace Corps Volunteer with dependents at home or elsewhere is often a challenge.
The Peace Corps requires a notarized letter from the person assuming responsibility for your dependent(s). This
must be submitted at the time of application submission. For additional information on required legal
documentation and sample notarized letter template please visit www.peacecorps.gov/legalinfo.

List all children under age 18, whether or not they are dependent upon you for financial support.
Name of child ____________________________
Address of child ____________________________
Date of birth ____________________________
Is this child dependent?
Yes
No

Name of child ____________________________
Address of child ____________________________
Date of birth ____________________________
Is this child dependent?
Yes
No

Name of child ____________________________
Address of child ____________________________
Date of birth ____________________________
Is this child dependent?
Yes
No

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List all other dependents (including former spouses, spouses remaining at home during service, children aged 18
or older, parents or other persons) not listed above for whom you have support obligations.
Name of dependent ____________________________
Address of dependent ____________________________
Date of birth ____________________________

Name of dependent ____________________________
Address of dependent ____________________________
Date of birth ____________________________

Name of dependent ____________________________
Address of dependent ____________________________
Date of birth ____________________________
Explain how you will continue to meet your support obligations while serving without a salary as a Peace Corps
Volunteer.

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Financial Obligations
Before you may serve in the Peace Corps, you must provide documentation establishing that you have made
arrangements satisfactory to your creditors or others to defer, pay, or otherwise fulfill all your financial obligations.
The Peace Corps reserves the right to request a credit report to verify your financial information. Your submission
of this application will be considered consent to request such a report.
The Peace Corps considers financial obligations to include such things as student loans, mortgage, credit card debt,
taxes, car loans, alimony, child support, etc.
Do you have any financial obligations, including student loans?
Yes
No

Student Loans
Please complete information below concerning your student loans if applicable.
Type of Student Loan __________________________
Amount __________________________
Principal Deferrable?
Yes
No
Interest Deferrable?
Yes
No

Type of Student Loan __________________________
Amount __________________________
Principal Deferrable?
Yes
No
Interest Deferrable?
Yes
No

Type of Student Loan __________________________
Amount __________________________
Principal Deferrable?
Yes
No
Interest Deferrable?

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Yes
No

Type of Student Loan __________________________
Amount __________________________
Principal Deferrable?
Yes
No
Interest Deferrable?
Yes
No

Call your student loan company about the possibility of deferment during Peace Corps service. If the loan is not
deferrable, please explain how you will meet this loan responsibility.
If someone is assuming payment of your student loans, the Peace Corps requires a notarized letter from the
person affirming the commitment to make those payments. This notarized letter must be submitted at the time of
application submission. For additional information on required legal documentation and sample notarized letter
template please visit www.peacecorps.gov/legalinfo.

Other Financial Obligations
Type of Financial Obligation __________________________
Description of Financial Obligation __________________________
Amount __________________________
Will this debt still be outstanding (unable to be paid in full, deferred, or otherwise fulfilled) at the time you would
potentially depart for Peace Corps training?
Yes
No
Type of Financial Obligation __________________________
Description of Financial Obligation __________________________
Amount __________________________
Will this debt still be outstanding (unable to be paid in full, deferred, or otherwise fulfilled) at the time you would
potentially depart for Peace Corps training?
Yes
No

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Type of Financial Obligation __________________________
Description of Financial Obligation __________________________
Amount __________________________
Will this debt still be outstanding (unable to be paid in full, deferred, or otherwise fulfilled) at the time you would
potentially depart for Peace Corps training?
Yes
No

Type of Financial Obligation __________________________
Description of Financial Obligation __________________________
Amount __________________________
Will this debt still be outstanding (unable to be paid in full, deferred, or otherwise fulfilled) at the time you would
potentially depart for Peace Corps training?
Yes
No

If you answered “Yes,” describe your plans to satisfy the obligation(s) while serving in the Peace Corps.

If someone is assuming payment of your financial obligation(s), the Peace Corps requires a notarized letter from
the person affirming the commitment to make those payments. This notarized letter must be submitted at the
time of application submission. For additional information on required legal documentation and sample notarized
letter template please visit www.peacecorps.gov/legalinfo.
If you have questions about these legal and financial issues, please visit www.peacecorps.gov/legalinfo. If you need
additional assistance, call the Peace Corps Legal Eligibility Office at 800.424.8580, select option 2 to reach
Headquarters, and dial extension 1845 for assistance.

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Military Status
Do you have any military service, including ROTC, National Guard, Reserves or the U.S. Armed Forces?
Yes
No
Are you currently serving in the ROTC, National Guard, Reserves, or the U.S. Armed Forces?
Yes
No
If yes, how will you fulfill your obligation? ___________________________________________
Have you ever served in the U.S. Armed Forces? If yes, please fill out the information below.
Branch _________________________
Highest rank held _________________________
Serial/File number _________________________
Dates of service from (mm/yyyy) _________________________
Dates of service to (mm/yyyy) _________________________
Type of discharge _________________________
If your discharge was other than honorable, explain the circumstances in detail below.

If you were honorably discharged from the military within the last 10 years or dishonorably discharged from the
military at any time, please submit a copy of your DD214 at the time of application submission. For additional
information on required legal documentation please visit www.peacecorps.gov/legalinfo.
Are you currently in the Inactive Ready Reserves (IRR) or expect to transfer to IRR status from active duty?
Yes
No

What date do you anticipate being transferred to IRR status? _____________________
Please note that you will be required to provide proof of IRR status prior to being invited to serve in the Peace
Corps.
The Peace Corps will not issue an invitation to serve until we have a copy of your official discharge papers. Please
plan accordingly.

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Drug and Alcohol Information
Peace Corps reserves the right to ask additional questions about drug and alcohol use.
The Peace Corps has a strict policy regarding the use of drugs and alcohol. As a Peace Corps Volunteer, you are
responsible for your personal conduct and professional performance 24/7 (Core Expectation 5). You must exercise
good judgment and personal responsibility to protect your health, safety, and well-being, and that of others (Core
Expectation 8). Please read the following carefully – your personal conduct is critical to your success as a Peace
Corps Volunteer.
Drugs
A Volunteer or trainee found to be involved with drugs in a manner not authorized for medical purposes, in any
way, in any country, will be administratively separated immediately. The Peace Corps enforces this strict policy
because the cultivation, manufacture, traffic, and use of drugs, including marijuana, is illegal in most countries.
Additionally, drug involvement by Volunteers and trainees in any country could seriously jeopardize the entire
Peace Corps program, as well as the safety and health of Volunteers and trainees.
Alcohol
Peace Corps leaves decisions regarding the use of alcohol to the discretion of the individual Volunteer or trainee.
However, the Peace Corps recognizes that excessive use of alcohol may compromise Volunteer or trainee safety
and security, lead to behavior that is a discredit to the Peace Corps or the individual, or affect a Volunteer’s or
trainee’s performance in an assignment. Examples of such behavior include but are not limited to: public
intoxication, drinking while at the work site, failure to appear for work or training due to intoxication or hangovers,
and verbal or physical aggressiveness while under the influence of alcohol. Such inappropriate or unsafe behavior
or inability to perform adequately in the assignment may be grounds for disciplinary action, including
administrative separation.
Peace Corps may deem an applicant ineligible or unsuitable for Peace Corps service due to the illegal use of drugs,
problem drinking, and/or abusive use of alcohol. The terms “problem drinking”, “abusive use of alcohol” and their
variants include, but are not limited to: binge drinking; feeling that you should cut down on your drinking;
experiencing concern from others who think that you drink too much; feeling bad or guilty about your drinking;
drinking in the morning to steady your nerves or to get rid of a hangover; or alcohol-related legal incidents.
Peace Corps Drug and Alcohol Policy
Applicants charged with, or convicted of, any drug-related offense are not eligible to have their applications
considered for Peace Corps service until one year has passed from the date of the offense, arrest, or conviction,
whichever is later.
Applicants charged with, or convicted of, public intoxication, DUI, DWI, or who receive a reduced charge of, or
conviction for, reckless driving from an initial charge of DUI or DWI, or who have a similar alcohol-related offense
in their legal history, are not eligible to have their application considered for Peace Corps service until one year has
passed from the date of the offense, arrest, or conviction, whichever is later. This includes arrests and citations.
Any arrest, citation, or other legal incident related to alcohol or illegal drugs that occur during the application
process, including up to the day of departure, will also disqualify an applicant. Any applicant who is disqualified for
the above reasons may reapply after one year.

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Legal Status and History
The existence of an arrest or conviction record will not automatically exclude an applicant from consideration
for service in the Peace Corps. When evaluating an applicant’s arrest or conviction information, Peace Corps
considers the nature of the offense(s), how long ago the offense(s) occurred, the nature of the position in
question, and other relevant facts or indicia of rehabilitation. If an applicant is ultimately rejected for a Peace
Corps Volunteer position because of an arrest or conviction in his or her background, the applicant has the
opportunity to appeal the decision and/or reapply at a later date.
All Peace Corps invitees must undergo a National Agency Check (NAC) background investigation to help
determine legal eligibility for service. The NAC is a criminal background investigation conducted by the United
States Office of Personnel Management (OPM). The NAC investigation consists of a search of OPM’s Security
and Suitability Investigations Index (SII), the Defense Clearance Investigations Index (DCII), a Federal Bureau of
Investigations (FBI) name check, and a FBI National Criminal History fingerprint check. The NAC investigation
will reveal all arrests and convictions regardless of disposition (i.e., suspended sentence, deferred judgment,
dismissal, not guilty, reduced charge, mistaken identity, or expungement). Therefore it is required that you
report your criminal record information regardless of whether the record in your case has been sealed,
expunged, or otherwise stricken from the court record. The NAC background investigation is typically initiated
after an applicant is invited to serve in a Peace Corps program. The NAC form and fingerprint charts will be
provided at a later date.
If you fail to disclose any required information, including about legal, financial, or drug and alcohol behavior, the
Peace Corps may revoke your invitation to serve, or disqualify you from Peace Corps service. Any misleading,
inaccurate, or incomplete information may be cause for disqualification or termination. In addition, any
intentionally false statement may be subject to fines and/or imprisonment pursuant to 18 U.S.C. Section 1001.
It is the responsibility of the applicant to inform the Peace Corps promptly throughout the application process of
any changes in his/her legal status including all arrests, charges, citations, misdemeanors and felonies and ALL drug
or alcohol related legal incidents. Do not include traffic violations for which the sentence consisted only of a fine of
$300 or less unless the incident involved drugs and/or alcohol.
Please answer the following questions. Answers should include all arrests, charges, citations, misdemeanors and
felonies and ALL drug or alcohol related legal incidents. The information provided will be used to help determine
your eligibility for Peace Corps service.

1.

Applicants with any alcohol or drug-related citations, arrest, or convictions in their legal history
will not have their application considered for Peace Corps service until one year has passed from
the date of arrest or conviction, whichever is later. Have you had any alcohol or drug related
citations, arrests or convictions within the past year?
Yes
No

2.

Have you ever been found guilty of an offense under section 404 of the Controlled Substance Act
(21 U.S.C. 844), while under the age of 21?
Yes
No

22

3.

Have you ever been cited for, arrested, charged with, or convicted of any offense(s)? Exclude
traffic fines of $300 or less unless the violation was alcohol or drug related.
Yes
No

4.

Are there currently any charges or probation pending against you for any criminal offense? For
additional information on what constitutes probation please visit www.peacecorps.gov/legalinfo.
Yes
No

5.

Have you ever been subject to a court martial or other disciplinary proceedings under the
Uniform Code of Military Justice? (Include non-judicial, Captain's mast, etc.)
Yes
No

6.

Are you currently a party to a civil suit?
Yes
No

7.

Are you expected to be a witness in a court or other proceeding during the time you would be
serving as a Peace Corps Volunteer?
Yes
No

8.

Did you answer “Yes” to any of the questions above?
Yes
No

If you answered “Yes” to any of the questions above, provide the applicable information below for the offense or
civil suit.

Type of offense/civil suit (e.g., DUI, possession of marijuana, petty theft, suing landlord): _____________________
Date of Incident: _____________________
Location of incident _____________________
Was there a final court judgment?

23

Yes
No

Judgment Date: _____________________
Current status or disposition: _____________________
List all penalties including sentence, probation, community service, fine or other penalty imposed:
_____________________
Explanation and detailed circumstances surrounding the offense/civil suit:

Additional offense (if applicable)
Type of offense/civil suit (e.g., DUI, possession of marijuana, petty theft, suing landlord): _____________________
Date of Incident: _____________________
Location of incident _____________________
Was there a final court judgment?

Yes
No

Judgment Date: _____________________
Current status or disposition: _____________________
List all penalties including sentence, probation, community service, fine or other penalty imposed:
_____________________
Explanation and detailed circumstances surrounding the offense/civil suit:

If you have additional offenses/civil suits, please submit a statement that includes the information requested
above as an attachment with your submission of this application.

24

Your application will not be considered without this information. It is your responsibility to inform the Peace Corps
promptly throughout the application process of any changes in your legal status, including arrests, charges,
citations, convictions, or legal eligibility. You may exclude parking tickets and traffic fines of $300 or less.

25

Intelligence Activities and Organizations
It has been the Peace Corps' longstanding policy to exclude from Peace Corps Volunteer service, in accordance
with Peace Corps Manual Section 611, any persons who have engaged in intelligence activity or related work or
who have been employed by or connected with an intelligence agency.
The policy is founded on the premise that it is crucial to the Peace Corps in carrying out its mission that there is a
complete and total separation of Peace Corps from the intelligence activities of the United States government,
both in reality and appearance. Any semblance of a connection between Peace Corps and the intelligence
community would seriously compromise the ability of the Peace Corps to develop and maintain the trust and
confidence of the people of the host countries. Serious doubts about an applicant's connection with intelligence
activities are to be resolved in favor of exclusion.
"Intelligence Activity" includes any activities or specialized training involving or related to the clandestine
collection of information, or the analysis or dissemination of such information, intended for the use by the United
States government in formulating or implementing political or military policy in regard to other countries. The
term "intelligence activity" includes any involvement in covert actions designed to influence events in foreign
countries.
Persons currently or formerly employed by the Central Intelligence Agency are permanently ineligible for Peace
Corps Volunteer service. Employment with other intelligence agencies may also be disqualifying. In addition,
applicants may be disqualified for service because their background or history discloses a substantial connection
with an intelligence activity or related work other than through employment. Even family relationships to an
employee of an intelligence agency may be considered a disqualifying connection. If you have a family member
who works for or has worked for the CIA, you should not complete the intelligence background questionnaire
until your family member has consulted with the CIA’s Office of General Counsel. Be advised for security
reasons, you may only contact your family member concerning your Peace Corps application in person (i.e. not
by email, phone, social networking, or any other means that is not in person).
Depending upon the nature of an applicant's involvement in or relationship to intelligence activities or agencies,
the duration of disqualification may range from a permanent disqualification, disqualification up to ten years, or
disqualification for ten years or more. Applicants are also advised that service as a Peace Corps Volunteer may
result in disqualification from employment with intelligence agencies of the U.S. Government for periods following
service as a Volunteer.
In some cases, employment or association with certain intelligence activities or agencies will result in Peace Corps
instructing you to contact those agencies who will coordinate with Peace Corps, as necessary and appropriate, to
assist Peace Corps in rendering a final decision on your application.
Based upon the preceding, please answer the following question:
Have you or a family member ever been employed by or connected with an intelligence agency, or engaged in
intelligence activity or related work?
Yes
No
If you indicated that either you or a family member has been employed by or connected to an intelligence agency,
or engaged in intelligence activity or related work, a representative from your recruiting office will contact you
after your application is submitted for additional information to determine if you are eligible to become a Peace
Corps Volunteer.

26

Are you currently applying for employment with an intelligence agency or other organization associated with
intelligence activities?
Yes
No

If yes, you will be required to withdraw all applications for employment with intelligence agencies after accepting
an invitation to serve in the Peace Corps and supply the Peace Corps with a copy of the letter to each agency
requesting the withdrawal of your application. More information regarding this will be provided at a later date.

27

Skills and Experience
Employment History
Your Peace Corps service is a commitment to improving the quality of life of the people with whom you live and
work and, in doing so, you will share your skills, adapt them, and learn new skills as needed (Core Expectation 2).
Starting with your most recent experience, please list at least 10 years of your employment history. Include any
self-employment and full-or part-time paid employment. You may list additional employment history if you believe
it is relevant to Peace Corps service. This section should be filled out completely. Stating "see resume" is not
acceptable.
Position 1
Position or Job Title _____________________
Organization Name _____________________
Hours per week _____________________
Start Month/Year (mm/yyyy) _____________________
End Month/Year (mm/yyyy) _____________________
Position 2
Position or Job Title _____________________
Organization Name _____________________
Hours per week _____________________
Start Month/Year (mm/yyyy) _____________________
End Month/Year (mm/yyyy) _____________________
Position 3
Position or Job Title _____________________
Organization Name _____________________
Hours per week _____________________
Start Month/Year (mm/yyyy) _____________________
End Month/Year (mm/yyyy) _____________________
Position 4
Position or Job Title _____________________
Organization Name _____________________
Hours per week _____________________
Start Month/Year (mm/yyyy) _____________________
End Month/Year (mm/yyyy) _____________________
Position 5
Position or Job Title _____________________
Organization Name _____________________
Hours per week _____________________
Start Month/Year (mm/yyyy) _____________________
End Month/Year (mm/yyyy) _____________________
Position 6
Position or Job Title _____________________
Organization Name _____________________
Hours per week _____________________
Start Month/Year (mm/yyyy) _____________________

28

End Month/Year (mm/yyyy) _____________________
Position 7
Position or Job Title _____________________
Organization Name _____________________
Hours per week _____________________
Start Month/Year (mm/yyyy) _____________________
End Month/Year (mm/yyyy) _____________________
Position 8
Position or Job Title _____________________
Organization Name _____________________
Hours per week _____________________
Start Month/Year (mm/yyyy) _____________________
End Month/Year (mm/yyyy) _____________________

Time Gaps
Do you have any time gaps greater than three months not otherwise accounted for by employment, school,
military, etc?
Yes,
No
If yes, please provide specific dates and reasons for each time gap. _____________________

29

Licenses and Certificates
Are you or will you be a state-certified teacher?
Yes
No
Teacher Certification
Please provide teacher certification information below, if applicable.
State: _______________________________
Subject: _______________________________
Grade Level: _______________________________
You must submit a copy of each current license/certificate at the time of application submission.
Other Certifications
Do you have other job-related current or former licenses or certificates? These could include but are not limited to
licenses or certificates in such things as TEFL, nursing, CPR and First Aid, nutrition, HIV/AIDS education, or skilled
trades including journeyman status. If so, please provide the following requested information.
Other Certifications 1
Type of License or Certificate _______________________________
Expiration Date _______________________________
State or other Licensing Agency _______________________________
Other Certifications 2
Type of License or Certificate _______________________________
Expiration Date _______________________________
State or other Licensing Agency _______________________________
Other Certifications 3
Type of License or Certificate _______________________________
Expiration Date _______________________________
State or other Licensing Agency _______________________________
Other Certifications 4
Type of License or Certificate _______________________________
Expiration Date _______________________________
State or other Licensing Agency _______________________________
You must submit a copy of each current license/certificate at the time of application submission.

30

Post-Secondary Education

You must submit a copy of transcripts from each post-secondary school attended within the past ten years at the
time of application submission. An unofficial copy of an official transcript is acceptable. All transcripts must include
your full name and the name of the school. List all schools attended regardless of attendance dates.
Transcripts from institutions outside of the United States must be translated into English and you must also include
documentation of the accreditation of the institution.
School 1
School Name __________________________________________
Type of degree, diploma or certificate __________________________________________
Date degree received or expected (mm/yyyy) __________________________________________
Major __________________________________________
Second Major __________________________________________
Minor __________________________________________

School 2
School Name __________________________________________
Type of degree, diploma or certificate (single-select) __________________________________________
Date degree received or expected (mm/yyyy) __________________________________________
Major __________________________________________
Second Major __________________________________________
Minor __________________________________________

School 3
School Name __________________________________________
Type of degree, diploma or certificate (single-select) __________________________________________
Date degree received or expected (mm/yyyy) __________________________________________
Major __________________________________________
Second Major __________________________________________
Minor __________________________________________

School 4
School Name __________________________________________
Type of degree, diploma or certificate (single-select) __________________________________________
Date degree received or expected (mm/yyyy) __________________________________________
Major __________________________________________
Second Major __________________________________________
Minor __________________________________________

School 5

31

School Name __________________________________________
Type of degree, diploma or certificate (single-select) __________________________________________
Date degree received or expected (mm/yyyy) __________________________________________
Major __________________________________________
Second Major __________________________________________
Minor __________________________________________

32

Master’s International
The Master's International Program offers a unique opportunity to combine Peace Corps service with a Master's
Degree program. Prospective students apply separately to Peace Corps and to a participating graduate school.
Once accepted by both, students will study on campus, usually for one year, and then spend the next two years
earning academic credit while working overseas in a related Peace Corps project. Most schools provide students in
this program with opportunities for research or teaching assistantships, scholarships while on campus or tuition
waivers for the credits earned while serving in the Peace Corps.
For additional information about Master's International visit www.peacecorps.gov/gradschool.

Please note that you must be accepted by the Master's International school before you can submit your application
for Peace Corps service.

Have you applied and been accepted to a Master's International program?
Yes,
No

Please indicate the school and program __________________________________________
Please submit your acceptance letter as an attachment at the time of application submission.
Your application is not complete without this acceptance letter.

33

Language Skills
Many assignments require previous language study. Please describe your language experience within the past 10
years below. You will have the opportunity to discuss your language skills in more detail during the interview
process.
Do you have any experience with a language other than English?
Yes
No
Language 1, if applicable
Language __________________________________________
Number of high school years __________________________________________
Number of college semesters/quarters __________________________________________
Highest level completed __________________________________________
Date of highest level completed (mm/yyyy) __________________________________________
Language Test taken __________________________________________
Language Test scores __________________________________________
Date of language test (mm/yyyy) __________________________________________
Informal language experience (briefly describe) __________________________________________

Language 2, if applicable
Language __________________________________________
Number of high school years __________________________________________
Number of college semesters/quarters __________________________________________
Highest level completed __________________________________________
Date of highest level completed (mm/yyyy) __________________________________________
Language Test taken __________________________________________
Language Test scores __________________________________________
Date of language test (mm/yyyy) __________________________________________
Informal language experience (briefly describe) __________________________________________

Language 3, if applicable
Language __________________________________________
Number of high school years __________________________________________
Number of college semesters/quarters __________________________________________
Highest level completed __________________________________________
Date of highest level completed (mm/yyyy) __________________________________________
Language Test taken __________________________________________
Language Test scores __________________________________________
Date of language test (mm/yyyy) __________________________________________
Informal language experience (briefly describe) __________________________________________

Language 4, if applicable

34

Language __________________________________________
Number of high school years __________________________________________
Number of college semesters/quarters __________________________________________
Highest level completed __________________________________________
Date of highest level completed (mm/yyyy) __________________________________________
Language Test taken __________________________________________
Language Test scores __________________________________________
Date of language test (mm/yyyy) __________________________________________
Informal language experience (briefly describe) __________________________________________

35

Community and Volunteer Activities
Peace Corps assignments require applicants to have leadership ability, creativity, initiative, flexibility, and a
willingness to work with others. You will engage with host country partners in a spirit of cooperation and mutual
learning and respect (Core Expectation 6) and respectfully integrate yourself into your host community and culture
(Core Expectation 4). Please describe your community, volunteer, or organizational experience that demonstrate
the following skills or abilities:
*Initiating or carrying out activities
*Planning activities involving others
* Organizing others to participate in activities or to perform tasks
* Motivating others to get and stay involved
* Leading, supervising, or managing others
In addition, many applicants have gained technical or subject skills relevant to Peace Corps assignments through
community and volunteer activities. You may have gained other skills not normally thought of as relevant to the
Peace Corps. Thus, it is important to be as complete as possible in describing your activities. List your most recent
activities first. Do not include experiences already listed in your employment history.
Volunteer Activity 1
Organization __________________________________________
Position Held __________________________________________
From (mm/yyyy) __________________________________________
To (mm/yyyy) __________________________________________
Hours per week __________________________________________
Name of Supervisor __________________________________________
Phone Number __________________________________________
Email Address __________________________________________
May we contact your supervisor?
Yes
No
Duties/ Achievements

Volunteer Activity 2
Organization __________________________________________
Position Held __________________________________________
From (mm/yyyy) __________________________________________
To (mm/yyyy) __________________________________________
Hours per week __________________________________________
Name of Supervisor __________________________________________
Phone Number __________________________________________
Email Address __________________________________________
May we contact your supervisor?
Yes

36

No
Duties/ Achievements

Volunteer Activity 3
Organization __________________________________________
Position Held __________________________________________
From (mm/yyyy) __________________________________________
To (mm/yyyy) __________________________________________
Hours per week __________________________________________
Name of Supervisor __________________________________________
Phone Number __________________________________________
Email Address __________________________________________
May we contact your supervisor?
Yes,
No
Duties/ Achievements

Volunteer Activity 4
Organization __________________________________________
Position Held __________________________________________
From (mm/yyyy) __________________________________________
To (mm/yyyy) __________________________________________
Hours per week __________________________________________
Name of Supervisor __________________________________________
Phone Number __________________________________________
Email Address __________________________________________
May we contact your supervisor?
Yes,
No
Duties/ Achievements

37

Practical Experience
As a Peace Corps Volunteer, you commit to improving the quality of life of the people with whom you live and
work, and in doing so, you share, adapt and learn new skills as needed (Core Expectation 2). The experience you
have gained from hobbies, volunteer activities, and work experience, including part-time or summer jobs, may
help you qualify for Peace Corps service. You will be asked if you have experience in any of the following skill
areas: Agriculture, Environment, Business, Information and Communication Technology (ICT), Education, Health,
Youth Work and Community Development, and Skilled Trades.
Please review each skill area in which you may have experience. If you indicate you have experience in a particular
skill area, please respond to the additional questions pertaining to that skill area.

Agriculture
Do you have any agriculture experience?
Yes
No
This could include but is not limited to experience in such things as:
4-H/FFA/FHA
Agroforestry and reforestation
Beekeeping
Crop extension
Farming
Fisheries
Food Security
Pest Management/Pathology
Soil Conservation
Vegetable Gardening

Agriculture Experience
1.

Do you have gardening/crops/horticulture experience?
a. If yes, provide the following information:
i. Dates of involvement (from mm/yyyy, to mm/yyyy) ___________________________
ii. Frequency of involvement (hours/days/weeks) ___________________________
iii. Type of food crops, vegetables, and fruits ___________________________
iv. Size of plot (# ft x # ft, or acres) ___________________________
v. Description of growing experience (including scale of garden such as personal,
community or commercial) ___________________________
b.

Describe any experience you have with the following:
i. Plowing and planting planning ___________________________
ii. Management of soil fertility ___________________________
iii. Pruning and grafting of fruit trees ___________________________
iv. Harvesting and storage methods ___________________________

38

Review the additional questions about your agriculture experience below. If you have experience with any of
these please provide the following information:
a. Dates (from mm/yyyy to mm/yyyy)
b. Frequency (hours per week/mo)
c. Description of experience
If you have multiple experiences for each area, list them in order from most to least recent.
2.

Do you have experience in agroforestry or agribusiness?
a. If yes, provide additional information. ___________________________

3.

Do you have experience in food security?
a. If yes, provide additional information. ___________________________

4.

Do you have experience working with 4H, Future Farmers of America (FFA), or other youth farmer
organizations?
a. If yes, provide additional information. ___________________________

5.

Do you have experience working with cattle, swine, poultry, sheep, goats or other farm animals?
a. If yes, provide additional information. ___________________________
b. Would you be willing to work on projects related to raising and slaughtering animals?
___________________________

6.

Do you have any beekeeping experience or would you be interested in receiving training for beekeeping
programs?
a. If yes, provide additional information. ___________________________
b. Have you ever had a bad reaction to bee stings? ___________________________

7.

Do you have any interest or experience in marine/fresh water fisheries?
a. If yes, provide additional information. ___________________________

8.

Do you have any other agriculture experience?
a. If yes, provide additional information. ___________________________

9.

How do you feel about the use of pesticides and/or herbicides? ___________________________

39

Environment
Do you have any environment experience?
Yes
No
This could include but is not limited to experience in such things as:
Appropriate Technologies
Conservation
Coastal Resource Management
Ecotourism
Energy
Environmental Awareness/Education
Forestry/Greenhouse/Nursery
Natural Resource Management
Protected Areas/Wildlife Management
Waste Management/Recycling

Environment Experience
Review the questions about your environment experience below. If you have experience with any of these
please provide the following information:
a. Dates (from mm/yyyy to mm/yyyy)
b. Frequency (hours per week/mo)
c. Description of experience
If you have multiple experiences for each area, list them in order from most to least recent.
1.

Do you have experience with appropriate technologies?
a. If yes, provide additional information. ___________________________

2.

Do you have experience with promoting environmental awareness in schools, communities, clubs, or
groups?
a. If yes, provide additional information. ___________________________

3.

Do you have experience with leading environmental education activities?
a. If yes, provide additional information. ___________________________

4.

Do you have experience with marketing environmentally sustainable products?
a. If yes, provide additional information. ___________________________

5.

Do you have experience with park interpretation or park guide work?
a. If yes, provide additional information. ___________________________

6.

Do you have experience with being a docent at a zoo or natural history museum?
a. If yes, provide additional information. ___________________________

7.

Do you have experience with tree planting?

40

a.

If yes, provide additional information. ___________________________

8.

Do you have experience with ecotourism?
a. If yes, provide additional information. ___________________________

9.

Do you have experience with leading waste management or recycling programs?
a. If yes, provide additional information. ___________________________

10. Do you have any other environment experience?
a. If yes, provide additional information. ___________________________

41

Business/Information and Communication Technology (ICT)
Do you have any business or ICT experience?
Yes
No
This could include but is not limited to experience in such things as:
Advertising/Graphic Design
Business Education/Training
Cooperatives/Credit Unions
Computer Literacy/Science/Networking/Repair
Entrepreneurship and Business Skills
Fundraising/Grant Writing/Marketing
Government
Media Technologies
Microfinance
Nonprofit Management
Organizational Management

Business/Information and Communication Technology (ICT) Experience
Review the questions about your business and ICT experience below. If you have experience with any of these
please provide the following information:
a. Dates (from mm/yyyy to mm/yyyy)
b. Frequency (hours per week/mo)
c. Description of experience
If you have multiple experiences for each area, list them in order from most to least recent.
1.

Do you have experience working with non-profits, non-governmental organizations (NGOs) or community
service organizations?
a.

If yes, provide additional information for each area below.
i.
Management experience, including strategic planning, organizational development (such as
working with/on the board of directors and staffing), coordinating volunteers, establishing
administrative controls: ___________________________
ii.

Program planning and implementation, community outreach and volunteer development
experience: ___________________________

iii.

Training experience, including number of volunteers/employees you trained, what skills you
taught, and training programs you designed: ___________________________

iv.

Resource development, fundraising, grant writing and membership drive experience:
___________________________

42

v.

2.

Do you have other business experience?
a.

3.

Budgeting, financial controls, including development of financial systems,
managing/developing budgets: ___________________________

If yes, provide additional information for each area below.
i. Management experience , including size of business, number of employees you supervised,
specific job responsibilities: ___________________________
ii.

Training experience, including number of employees you trained, what skills you taught, and
training programs you designed: ___________________________

iii.

Budgetary control, financial planning, cost analysis: ___________________________

iv.

Bookkeeping, including setting up ledgers/journals, posting to accounts, and systems you
created: ___________________________

v.

Marketing experience, including distribution systems, test marketing, market research:
___________________________

Do you have experience with computers, radio, video, internet, or other information technology?
Yes
No

a.

What applications have you used?
Word Processing (e.g., Microsoft Word, iWork Pages, etc)
Spreadsheets (e.g., Microsoft Excel, iWork Numbers, etc)
Databases (e.g., Microsoft Access, Oracle, SQL, etc)
Presentation Software (e.g., Microsoft PowerPoint, iWork Keynote, etc)
Desktop Publishing (e.g., Microsoft Publisher, Adobe InDesign, etc)
Email and office management (e.g., Microsoft Outlook, etc)
Social Networking (e.g., Facebook, Twitter, etc)
Blogging (e.g., Blogger, Word Press, etc.)
None

b.

What operating systems have you used?
Windows
Mac OS
UNIX/Linux
Others
None

c.

Have you done systems administration or computer lab setup for:
Windows networks
Mac OS networks
UNIX/Linux networks
Others
I have not done this type of work.

43

d.

Have you done repair, maintenance, network development for systems using:
Windows
Mac OS
UNIX/Linux
Others
I have not done this type of work.

e.

Have you done website or wiki development (using tools such as Adobe Dreamweaver or coding raw
HTML)? _________________________________

f.

Do you have experience developing “edutainment” or E-learning tools?
_________________________________

g.

Do you have experience working with radio production systems or audio editing?
_________________________________

h.

Do you have experience working with video production systems or video editing?
_________________________________

i.

Do you have experience working with mobile phone application development?
_________________________________

j.

Do you have experience working with GIS / GPS / Google Earth?
_________________________________

k.

Do you have computer teaching or training experience?
If yes, provide information on the number of people trained and the skills taught.
_________________________________

4.

Do you have any other business or ICT experience?
If yes, provide additional information.

44

Education
Do you have any education experience?
Yes
No
This could include but is not limited to experience in such things as:
Adult Education
Art/Drama
Deaf Education
English/ESL/TEFL Teaching or Tutoring
Literacy/Reading
Math Education
Primary/Secondary/University Teaching
Science Education
Teacher Training

Education Experience
Review the questions about your education and teaching experience below. If you have experience with any of
these please provide the following information:
a. Dates (from mm/yyyy to mm/yyyy)
b. Frequency (hours per week/mo)
c. Subject taught
d. Grade level
e. Class/group size
f. Formal classroom or informal teaching or tutoring experience
g. Description of experience. This could include experience with lesson planning, co-teaching,
classroom management, workshop development, etc.
If you have multiple experiences for each area, list them in order from most to least recent.
th

1.

Do you have experience with primary education? Primary is defined as K-5 grade.
a. If yes, provide additional information. ____________________________________________

2.

Do you have experience with middle school education? Middle school is defined as 6 – 8 grade.
a. If yes, provide additional information. ____________________________________________

3.

Do you have experience with secondary education? Secondary is defined as 9 -12 grade.
a. If yes, provide additional information. ____________________________________________

4.

Do you have experience with university teaching?
a. If yes, provide additional information. ____________________________________________

5.

Do you have experience training teachers?
a. If yes, provide additional information. ____________________________________________

6.

Do you have experience with special education?

th

th

th

th

45

a.

If yes, provide additional information. ____________________________________________

7.

Do you have other education or teaching experience?
a. If yes, provide additional information. ____________________________________________

8.

Please provide information on any education-related professional development training you have
completed. Include the institution name, topics covered, dates, and training hours.

46

Health
Do you have any health experience?
Yes
No
This could include but is not limited to experience in such things as:
Disease Prevention
Family Planning
Health Outreach
HIV/AIDS Education
Hospice
Malaria Control
Maternal Health
Nutrition
Reproductive and Sexual Health
Water and Sanitation Hygiene Education

Health Experience
Review the questions about your health experience below. If you have experience with any of these please
provide the following information:
a. Dates (from mm/yyyy to mm/yyyy)
b. Frequency (hours per week/mo)
c. Description of experience
If you have multiple experiences for each area, list them in order from most to least recent.

1.

Do you have experience with providing health education or outreach?
a. If yes, provide additional information. ____________________________________________

2.

Do you have experience with providing HIV/AIDS education?
a. If yes, provide additional information. ____________________________________________

3.

Do you have experience with hospice care?
a. If yes, provide additional information. ____________________________________________

4.

Do you have experience with malaria control?
a. If yes, provide additional information. ____________________________________________

5.

Do you have experience with maternal health education?
a. If yes, provide additional information. ____________________________________________

6.

Do you have experience with nutrition?
a. If yes, provide additional information. ____________________________________________

7.

Do you have experience with providing family planning, reproductive or sexual health education?

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a.

If yes, provide additional information. ____________________________________________

8.

Do you have experience with providing water and sanitation hygiene education?
a. If yes, provide additional information. ____________________________________________

9.

Do you have any other health experience?
a. If yes, provide additional information. ____________________________________________

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Youth Work and Community Development
Do you have any youth work or community development experience?
Yes
No
This could include but is not limited to experience in such things as:
At-Risk youth work
Camp Counselor
Capacity Building
Civic Engagement
Community mobilization
Employment training
Gender in Development
Social Work/Counseling
Sports Coaching/Physical Education
Teambuilding/Leadership

Youth and Community Development Experience
Review the questions about your youth and community development experience below. If you have experience
with any of these please provide the following information:
a. Dates (from mm/yyyy to mm/yyyy)
b. Frequency (hours per week/mo)
c. Description of experience
If you have multiple experiences for each area, list them in order from most to least recent.
1.

Do you have experience working with youth?
a. If yes, provide additional information for each area below.
i. At risk youth experience. (At-risk youth are defined as youth between the ages of 10 and
25 who are one or more of the following: out of work, school drop-outs, have
substance, physical or mental abuse issues, live in extreme poverty, or are from
dysfunctional families). ____________________________________________
ii. Camp counselor experience: ____________________________________________
iii. Income-generating or entrepreneurial experience:
____________________________________________
iv. Social work, counseling, or conflict resolution experience:
____________________________________________
v. Sports coaching and/or physical education experience:
____________________________________________
vi. Youth leadership experience: ____________________________________________

49

2.

Do you have experience with community development?
a. If yes, provide additional information for each area below.
i. Capacity building experience: ____________________________________________
ii. Civic engagement or volunteer management experience:
____________________________________________
iii. Community mobilization experience:
____________________________________________
iv. Community service experience: ____________________________________________
v. Gender and development experience:
____________________________________________
vi. Program development including planning, designing and implementing programs or
activities, such as conducting community assessments and public outreach.
____________________________________________
vii. Team/group leadership experience:
____________________________________________

3.

Do you have any other youth or community development experience?
a. If yes, provide additional information. ____________________________________________

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Skilled Trades
Do you have any skilled trades experience?
Yes
No
This could include but is not limited to experience in such things as:
Construction
Home Repair and Remodeling
Masonry
Plumbing
Vocational Education
Woodworking
Skilled Trades Experience
Review the questions about your skilled trades experience below. If you have experience with any of
these please provide the following information:
a. Dates (from mm/yyyy to mm/yyyy)
b. Frequency (hours per week/mo)
c. Description of experience (including materials and tools used)
If you have multiple experiences for each area, list them in order from most to least recent.
1.

Do you have experience with construction?
a. If yes, provide additional information. ____________________________________________

2.

Do you have experience with home repair or remodeling?
a. If yes, provide additional information. ____________________________________________

3.

Do you have experience with masonry?
a. If yes, provide additional information. ____________________________________________

4.

Do you have experience with plumbing?
a. If yes, provide additional information. ____________________________________________

5.

Do you have experience with vocational education?
a. If yes, provide additional information. ____________________________________________

6.

Do you have experience with woodworking?
a. If yes, provide additional information. ____________________________________________

7.

Do you have other experience in skilled trades?
a. If yes, provide additional information. ____________________________________________

8.

Do you have journeyman status?
a. If yes, indicate the area of journeyman status, expiration date, and state or other licensing
agency. Please upload a copy of your certification to your application prior to submission.
____________________________________________

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Interest and Availability
Assignment and Regional Interests

How and where the Peace Corps assigns Volunteers is based largely on matching the educational and work
experience of applicants with the kinds of skills and projects for which countries have requested assistance. As a
result, the Peace Corps cannot guarantee placement in any specific region or country. Our priority is to place an
applicant where his or her skills are most needed, which may be under conditions of hardship (Core Expectation 3).
Applicants who are flexible about where they will go and what they will do are therefore more competitive.
The Peace Corps’ mission supports the needs of communities and honors the request of host countries in providing
Volunteers where they are needed most. We review your potential skill areas, where those skills are needed, your
health status, where noted concerns can best be accommodated, and the relationship between your availability
for service and when groups of trainees are beginning service. Your regional interest, if any, is a consideration only
when all other conditions are met.
Please indicate the work assignments in which you have an interest.
Agriculture
Environment
Business
Information and Communication Technology
Education
Health
Youth Work and Community Development
Skilled Trades
Visit the Peace Corps website at www.peacecorps.gov/assignments for more information about work assignments.

Which regions, if any, would you be unwilling to serve in as a Peace Corps Volunteer?
Open to serve in all regions
Africa
Asia
Caribbean
Central / South America
Central Asia
Eastern / Central Europe
North Africa / Middle East
Pacific Islands
Briefly explain why you are unwilling to serve in these regions.
____________________________________________
The Peace Corps does not generally place Volunteers in countries where they may have family or other potential
connections or relationships that could create distractions or conflicts of interest. Please list all Peace Corps
countries where you have family members or such other connections.
____________________________________________

52

Earliest Availability
What is the earliest date you can be available for Peace Corps service? You will be considered for assignments
beginning after this date. You must notify your recruiter if this date changes.
____________________________________________
Candidates should apply no more than one year prior to their date of availability, with the exception of Master's
International candidates, whose availability is determined by their individual academic program.

53

References
References
We require three letters of recommendation. Please notify your references as soon as you start your application.
Your references will only be contacted if you pass the initial screening. We suggest that you encourage your
references to respond within two weeks of receiving the Peace Corps’ request.
Recommendations should be from each of the following individuals:
A current or previous employment supervisor
A current or previous volunteer work supervisor
A close friend who has known you for at least two years
You will not be considered for Peace Corps service without these three recommendations. If you do not have a
work supervisor, please use another previous employment supervisor or a professor from your academic
department. If you do not have a volunteer supervisor, please substitute a previous job supervisor or a professor
from your academic department. You will be asked to provide additional information concerning substitute
references. Recommendations will not be accepted from family members or persons with whom you are
romantically involved. If you have any questions regarding appropriate references, please contact your local
regional recruiting office by calling 1.800.424.8580 and choosing option 1.
We prefer online submission of recommendations as it streamlines the application process. However, if one or
more of your recommendation providers is unable to complete the online form, please visit
www.peacecorps.gov/legalinfo to download a paper reference or contact your regional recruiting office and
request that paper copies of the reference form be mailed to you. You must then print out the reference form and
send it to your recommender. The completed paper reference form must be placed in a sealed envelope with the
recommender’s signature across the seal, and returned to you. You must then provide the completed reference(s)
to your regional recruiting office.
Please note:
Your recommendations will automatically be matched to your application upon submission.
To complete the recommendation online, a recommendation provider must have a valid email address.
Returned Peace Corps Volunteers who completed or ended service in the last five years are required to
submit an additional reference from a Peace Corps staff person from their country of service.
Reference 1 – Job Supervisor
If you do not have a current Job Supervisor, please substitute a previous Job Supervisor Reference or a professor
from your academic department.
Reference Type (Job Supervisor, Volunteer Supervisor, Personal Reference, Professor) _______________________
Reference Name (First and Last Name) _______________________
Reference Email Address (if recommender does not have an email address, please enter “N/A”)
_______________________

Reference 2 – Volunteer Supervisor

54

If you do not have a Volunteer Supervisor, please substitute a previous Job Supervisor Reference or a professor from
your academic department.
Reference Type (Job Supervisor, Volunteer Supervisor, Personal Reference, Professor) _______________________
Reference Name (First and Last Name) _______________________
Reference Email Address (if recommender does not have an email address, please enter “N/A”)
_______________________

Reference 3 – Personal Reference
Reference Type (Job Supervisor, Volunteer Supervisor, Personal Reference, Professor) _______________________
Reference Name (First and Last Name) _______________________
Reference Email Address (if recommender does not have an email address, please enter “N/A”)
_______________________

Substitutions
If you chose to substitute a reference type above, please justify the reason for the substitution(s) here.
___________________________________________
Returned Peace Corps Volunteers who completed service in the last five years are required to submit an additional
reference from a Peace Corps staff person from their country of service.
Are you a Returned Peace Corps Volunteer who completed service within the past five years?
Yes
No

If yes, complete staff reference information below.
Peace Corps Staff Reference
Reference Name (First and Last Name) _______________________
Country of Service _______________________
Reference Email Address _______________________

55

Essay Questions
Essays
The two essay questions below will provide the Peace Corps with additional information and insights that will be
used to assess your suitability for Peace Corps service. If you are invited to serve as a Peace Corps Volunteer, your
essays may be shared with staff in your country of service.
Please read both questions below and provide written responses between 250-500 words each.
Both essays are mandatory. Your application will not be considered without them.
Motivation Statement
Peace Corps service presents major physical, emotional, and intellectual challenges. You have provided
information on how you qualify for Peace Corps service elsewhere in the application. In the space below, please
provide a statement (between 250-500 words) that includes:
* Your reasons for wanting to serve as a Peace Corps Volunteer; and
* How these reasons are related to your past experience and life goals.
* How you expect to satisfy the Peace Corps 10 Core Expectations (rather than addressing all 10 expectations,
please be specific about which expectations you anticipate to find most challenging and how you plan to overcome
these challenges).

56

Cross Cultural Essay
Your success as a Peace Corps Volunteer is based on the trust and confidence you build by living in, and
respectfully integrating yourself into, your host community and culture (Core Expectation 4). Describe in between
250-500 words an experience you have had living or working in a social or cultural environment different from
your own. What specific challenges did you face concerning trust, confidence, and/or integration? What did you
learn from this experience that you will bring with you to your Peace Corps service?

57

Attachments
Attachments
Please provide any of the following attachments, if applicable, with your application submission. For additional
information on required legal documentation and sample notarized letter templates please visit
www.peacecorps.gov/legalinfo
List of Potential Attachments
1. Marriage Certificate
2. Divorce Decree(s) / Legal Separation documentation
3. Notarized Letter regarding Dependents
4. Notarized Letter regarding Serving Without Spouse
5. Military Discharge Paperwork (DD214)
6. Notarized Letter regarding Student Loans / Financial Obligations
7. Transcript(s)
8. Master’s International Acceptance Letter
9. Licenses / Certificates
10. Other attachments

Attachment Acknowledgement

Please read and respond to each question below. All questions are required. If an attachment does not apply to
you, select "N/A."
With few exceptions, all necessary attachments are required prior to application submission.
Married applicants planning to serve with their spouse are required to provide a copy of their marriage certificate.
1.

If you are currently married and planning to serve with your spouse, have you submitted a copy of your
marriage certificate?
Yes
No
N/A

Married applicants planning to serve without their spouse are required to provide a copy of a notarized letter from
their spouse.
2.

If you are currently married and planning to serve without your spouse, have you submitted a copy of a
notarized letter from your spouse?
Yes
No
N/A

58

Divorced or legally separated applicants are required to provide copies of all legal documents related to each
divorce or legal separation. If a former divorced spouse is deceased, it is not necessary to submit a final divorce
decree.
3.

If you have been divorced or you are legally separated, have you submitted a copy of all relevant legal
documents?
Yes
No
N/A

Applicants with dependents are required to provide a notarized letter from the person assuming responsibility for
all dependents.
4.

If you have dependents, have you submitted a copy of a notarized letter from the person assuming
responsibility for all dependents, affirming responsibility?
Yes
No
N/A

Applicants who have someone else assuming payments for student loans are required to provide a copy of a
notarized letter from that person affirming the commitment to make the payments.
5.

If you have student loans that someone else is assuming payments on, have you submitted a copy of the
notarized letter from that person?
Yes
No
N/A

Applicants who have someone else assuming payments for financial obligations are required to provide a copy of a
notarized letter from that person affirming the commitment to make those payments.
6.

If you have financial obligations for which someone else is assuming payments, have you submitted a
copy of the notarized letter from that person?
Yes
No
N/A

Applicants who have been honorably discharged from the military within the last 10 years, dishonorably
discharged from the military at any time or are in the Inactive Ready Reserves are required to provide a copy of
their DD214.
7.

If you were in the military and fit into one of the categories above, have you submitted a copy of your
DD214?

59

Yes
No
N/A

Applicants with a teaching certification or other applicable licenses and/or certificates are required to provide
copies of these licenses and/or certificates.
8.

If you have any licenses and/or certificates, have you submitted a copy of these to the application?
Yes
No
N/A

Applicants who have attended a post-secondary school within the past ten years are required to provide a copy of
the transcripts from that school. An unofficial copy of an official transcript is acceptable. All transcripts must
include your full name and the name of the school.
9.

If you have attended any post-secondary school within the last ten years, have you submitted copies of all
transcripts?
Yes
No
N/A

Applicants participating in the Master’s International program must be accepted by the Master's International
school before they can submit their application for Peace Corps service.
10. If you are a Master’s International applicant, have you submitted a copy of your acceptance letter?
Yes
No
N/A

If you answered “No” to any of these questions, please provide an explanation for not attaching the required
documents below.
________________________________________________________________________________________

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Request for Racial and Ethnic Data
Request for Racial and Ethnic Data
This information is voluntary. Your response will not affect consideration of your application. By providing this
information, you will assist in assuring that the Peace Corps is administered in a nondiscriminatory manner and
reflects the diversity of the United States. The information requested in this section is covered by the Privacy Act
Notice.
Ethnicity
Please check one of the classifications in the Ethnicity section below.
Hispanic or Latino (a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish
culture or origin, regardless of race. The term, "Spanish" origin can be used in addition to "Hispanic" or
"Latino")
Not Hispanic or Latino
Race
Please check one or more of the classifications in the Race section below.
American Indian or Alaska Native (a person having origins in any of the original peoples of North and
South
America (including Central), and who maintains tribal affiliation or community attachment.)
Asian (a person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian
subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the
Philippine Islands, Thailand, and Vietnam)
Black or African American (a person having origins in any of the black racial groups of Africa. Terms such
as "Haitian" or "Negro" can be used in addition to "Black" or "African American")
Native Hawaiian or Other Pacific Islander (a person having origins in any of the original peoples of Hawaii,
Guam, Samoa, or other Pacific Islands)
White (a person having origins in any of the original peoples of Europe, the Middle East, or North Africa)

61

Confirmation
Privacy Act and Paperwork Reduction Notice
The Peace Corps, an agency of the federal government, is required by the Privacy Act of 1974 (5 U.S.C. 552a) to
advise you of the following information regarding this application. The Privacy Act addresses the federal
government’s use of certain personal information in agency files.
A. This application is authorized by the Peace Corps Act (22 U.S.C. 2501 et seq.) as amended.
B. This information you provide will be used is to evaluate your suitability and qualifications to serve as a Peace
Corps Volunteer.
C. This information may be used for the routine uses described in the Privacy Act, 5 U.S.C. 552a, and Peace Corps'
published Routine Uses, summarized in Peace Corps' System of Records.
D. The completion of this form is voluntary. However, failure to complete the application will result in the Peace
Corps being unable to assess your qualifications and may preclude your consideration for the Peace Corps.
E. The Peace Corps estimates that it will take 6 hours to complete this form. The Peace Corps may not conduct or
sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid
OMB control number.
OMB Control Number: 0420-0005
Expiration Date: ----PLEASE NOTE: The Peace Corps does not discriminate based on race, color, religion, sex, national origin, age (over
40), disability, sexual orientation, marital status, political affiliation, union membership, or history of participation
in either the EEO or grievance process. Anyone who feels he or she has been discriminated against should contact
the Peace Corps American Diversity Office, (202) 692-2139, [email protected], 1111 20th Street, NW,
Washington, D.C. 20526

Certification
I CERTIFY that all of the statements made on all pages of this application, including attachments, are true, correct,
and complete to the best of my knowledge and are made in good faith. I understand that any misleading,
inaccurate, or incomplete information may be cause for disqualification or termination from Peace Corps service.
In addition, any intentionally false statement or intended omission may be subject to fines and/or imprisonment
pursuant to 18 U.S.C. 1001.
I also understand it is my responsibility throughout the application process to inform the Peace Corps promptly of
any changes to the information provided here.
Signature _____________________________________________
Date __________________________

62

If you live in….

Mail your completed form to this Peace Corps office:

Alabama, Florida, Georgia,
Mississippi, Puerto Rico, South
Carolina, Tennessee, or the U.S.
Virgin Islands

Atlanta Regional Recruitment Office
60 Forsyth Street, Suite 3M-40
Atlanta, GA 30303

Fax 404.562.3455
Questions? 404.562.3456
[email protected]

Central and Eastern
Massachusetts, Maine, New
Hampshire, Rhode Island, or
Vermont

Boston Regional Recruitment Office
10 Causeway Street, Suite 559
Boston, MA 02222

Fax 617.565.5539
Questions? 617.565.5555
[email protected]

Illinois, Indiana, Iowa, Kentucky,
Michigan, Minnesota, Missouri,
North Dakota, Ohio, South
Dakota, or Wisconsin

Chicago Regional Recruitment Office
55 West Monroe Street, Suite 450
Chicago, IL 60603

Fax 312.353.4192
Questions? 312.353.4990
[email protected]

Arkansas, Colorado, Kansas,
Louisiana, Nebraska, New
Mexico, Oklahoma, Texas, Utah,
or Wyoming

Dallas Regional Recruitment Office
1100 Commerce Street, Suite 427
Dallas, TX 75242

Fax 214.253.5401
Questions? 214.253.5400
[email protected]

Arizona or Southern California

Los Angeles Regional Recruitment Office
2361 Rosecrans Avenue, Suite 155
El Segundo, CA 90245

Fax 310.356.1125
Questions? 310.356.1100
[email protected]

Washington DC, Delaware,
Maryland, North Carolina,
Virginia, or West Virginia

Mid-Atlantic Regional Recruitment Office
Peace Corps Headquarters
th
1111 20 Street, NW
Washington, DC 20526

Fax 202.692.1065
Questions? 202.692.1040
[email protected]

Connecticut, New Jersey, New
York, Pennsylvania, or Western
Massachusetts

New York Regional Recruitment Office
201 N. Varick Street, Suite 1025
New York, NY 10014

Fax 212.352.5441
Questions? 212.352.5440
[email protected]

Northern California, Hawaii, or
Nevada

San Francisco Regional Recruitment Office
1301 Clay Street, Suite 620N
Oakland, CA 94612

Fax 510.452.8441
Questions? 510.452.8444
[email protected]

Alaska, Idaho, Montana, Oregon,
or Washington

Seattle Regional Recruitment Office
1601 Fifth Avenue, Suite 605
Seattle, WA 98101

Fax 206.553.2343
Questions? 206.553.5490
[email protected]

63