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pdfAmeriCorps National Civilian Community Corps (NCCC)
Service Project Application Instructions
Table of Contents
INTRODUCTION ............................................................................................................................................. 2
AMERICORPS NCCC ....................................................................................................................................... 2
AMERICORPS NCCC MEMBERS ..................................................................................................................... 2
AMERICORPS NCCC SERVICE PROJECTS ........................................................................................................ 3
AMERICORPS NCCC PROJECT FOCUS AREAS................................................................................................. 3
NATURAL AND OTHER DISASTERS ................................................................................................... 3
INFRASTRUCTURE IMPROVEMENT .................................................................................................. 3
ENVIRONMENTAL STEWARDSHIP AND CONSERVATION ................................................................. 3
ENERGY CONSERVATION ................................................................................................................. 4
URBAN AND RURAL DEVELOPMENT ................................................................................................ 4
THE APPLICATION PROCESS: AN OVERVIEW ................................................................................................ 5
STEP 1: COMPLETE AN AMERICORPS NCCC PROJECT CONCEPT FORM (PCF) ................................. 5
STEP 2: COMPLETE THE AMERICORPS NCCC SERVICE PROJECT APPLICATION ............................... 5
PROJECT APPLICATION REVIEW AND APPROVAL ............................................................................ 5
STEP 1: AMERICORPS NCCC PROJECT CONCEPT FORM - INSTRUCTIONS ..................................................... 7
APPLICANT INFORMATION .............................................................................................................. 7
PROJECT INFORMATION .................................................................................................................. 8
FOCUS AREAS ................................................................................................................................... 8
NARRATIVES ..................................................................................................................................... 8
LOCATIONS....................................................................................................................................... 9
PROJECT CONCEPT FORM SIGNATURE .......................................................................................... 11
SUBMISSION INSTRUCTIONS ......................................................................................................... 11
STEP 2: AMERICORPS NCCC SERVICE PROJECT APPLICATION - INSTRUCTIONS ......................................... 12
APPLICANT INFORMATION ............................................................................................................ 12
PROJECT INFORMATION ................................................................................................................ 13
OTHER ............................................................................................................................................ 13
LOCATIONS..................................................................................................................................... 15
NARRATIVES ................................................................................................................................... 18
FOCUS AREAS AND OBJECTIVES ..................................................................................................... 22
APPLICATION ATTACHMENT LIST .................................................................................................. 22
PROJECT APPLICATION SIGNATURE ............................................................................................... 23
SUBMISSION INSTRUCTIONS ......................................................................................................... 23
Appendix A – AmeriCorps NCCC Regional Contact Information.................................................... 24
INTRODUCTION
The Corporation for National and Community Service (CNCS) is a federal agency that improves lives,
strengthens communities, and fosters civic engagement through service and volunteering. By
implementing several programs including AmeriCorps, Senior Corps and the Social Innovation Fund,
CNCS provides opportunities for Americans of all ages and backgrounds to serve their communities and
country. More than two million Americans will serve through these programs to support thousands of
national and community nonprofit organizations, faith-based groups, schools, and local agencies to
meet community needs in economic opportunity, education, environmental stewardship, healthy
futures, veteran and military families and other critical areas. National and community service programs
work closely with traditional volunteer organizations to broaden, deepen, and strengthen the ability of
citizens to contribute not only to their communities, but also to our nation.
AMERICORPS NCCC
One of the programs of CNCS, AmeriCorps National Civilian Community Corps (NCCC), is a full-time,
residential, national service program whose mission is to strengthen communities and develop leaders
through direct, team-based national and community service. Each year hundreds of young adults, ages
18-24, serve for 10 months as NCCC members on diverse teams of 8 to 12 people at one of five regional
campuses.
AmeriCorps NCCC teams are assigned 3-5 service projects throughout their 10 month service term,
primarily in the 8-10 states within that region. Service projects help to meet critical community needs in
the areas of natural and other disasters, infrastructure improvement, environmental stewardship and
conservation, energy conservation, and urban and rural development. Teams are available to support
community and faith-based based organizations, national nonprofits, schools, local-, regional-, and
federal municipalities, national and state parks, and Native American and Alaskan Native tribes.
Throughout AmeriCorps NCCC’s 20 years of service, teams of members have assisted communities in
preparedness, mitigation, response, recovery from the effects of natural disasters, constructed and
rehabilitated low-income housing, built and repaired trails, lead and managed community volunteers,
installed energy efficient modifications to homes, businesses and public facilities and addressed many
other local needs. Since 1994, more than 21,000 people have served in AmeriCorps NCCC, providing
assistance to hundreds of thousands of Americans.
AMERICORPS NCCC MEMBERS
Members are young men and women, ranging in age from 18 to 24 years old, and represent a wide
variety of socio- economic, cultural, geographic, and educational backgrounds. They include those with
graduate degrees and some who are working towards their high school equivalency diplomas. All
members have earned their place on an NCCC team by demonstrating a commitment to serve
communities and a desire make the nation stronger through 10 months of national service. The rewards
for their service include: an increased understanding about how active citizenship can make a positive
difference in the lives of others and build stronger communities, technical and interpersonal skills that
will serve them well in the future, and an education award that will enable them to either continue their
education or reduce educational debt.
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AMERICORPS NCCC SERVICE PROJECTS
NCCC accomplishes its mission by working with local community organizations and groups to help meet
a community need that would not be fully addressed without additional assistance. Rather than
providing cash grants, the AmeriCorps NCCC program places teams to serve with sponsoring
organizations. These projects are generally 6 to 13 weeks in duration, but will vary depending on the
specific requirements of each project. Projects must be capable of fully engaging at least one full team
of 8 to 12 members effectively. Transportation and some basic tools are provided by AmeriCorps NCCC,
however, project sponsors are required to provide materials, specialized tools, orientation, training, and
technical supervision. The project sponsor is responsible for arranging lodging for the team and works
with AmeriCorps NCCC staff prior to the start of the project to arrange for meal and other logistical
needs.
AMERICORPS NCCC PROJECT FOCUS AREAS
NATURAL AND OTHER DISASTERS
Natural and Other Disaster projects address the needs of communities affected by floods, hurricanes,
wildfires, and other disasters. These projects span the entire disaster cycle from preparedness,
mitigation, and readiness to response and recovery. Natural and Other Disaster projects aim to protect
communities and habitats from disaster and fire damage, strengthen communities’ abilities to prepare
for and mitigate disasters, help communities to more thoroughly or quickly rebuild after disasters, and
strengthen communities’ abilities to respond to and recover from disasters. In addition, projects often
help those in communities improve or restore housing and assist in more thoroughly or efficiently
meeting medical and basic human needs of those in disaster areas. Furthermore, many Natural and
Other Disaster projects aim to enhance organization capacity and capabilities to provide disaster
services to communities nationwide. Examples of service activities for these projects include:
supporting disaster centers, shelters, and facilities; preparing and distributing meals; mucking and
gutting homes and buildings; surveying community assets; and distributing educational materials and
preparedness kits.
INFRASTRUCTURE IMPROVEMENT
Infrastructure Improvement projects address the needs of communities by contributing to the safety
and well-being of community citizens through the repair and building of public structures. Infrastructure
Improvement projects aim to improve quality and accessibility of public infrastructure, preserve cultural
and historic integrity of communities, and enhance public spaces. Examples of service activities for these
projects include: building and repairing wheelchair ramps, boardwalks and footbridges; assembling
playgrounds; repairing and painting public facilities; renovating museums, historical buildings and
cemeteries, and restoring and refurbishing picnic areas and campsites.
ENVIRONMENTAL STEWARDSHIP AND CONSERVATION
In the tradition of the Civilian Conservation Corps of the 1930s, Environmental Stewardship and
Conservation projects address the needs of communities by helping them maintain and protect their
natural resources. Environmental Stewardship and Conservation projects aim to preserve, protect, and
enhance parks, natural habitats, and at-risk ecosystems as well as improve knowledge and
understanding of environmental conservation practices in communities nationwide. Examples of service
activities for these projects include: trail building and maintenance; planting trees; removing invasive
plant species; cleaning up rivers, streams, and wetlands; and facilitating environmental education
workshops and camps for youth.
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ENERGY CONSERVATION
Energy Conservation projects address the needs of communities by helping citizens to more effectively
and efficiently utilize their local resources. Energy Conservation projects aim to increase community
energy efficiency, increase use and application of sustainable energy technology, and improve
knowledge and understanding of sustainable energy practices in communities nationwide. Examples of
service activities for these projects include: conducting energy efficiency assessments; assisting with
installations of energy efficient modifications to homes, businesses, and public facilities; developing and
improving recycling programs; performing home weatherization projects; and facilitating educational
programming on energy sustainability and conservation practices.
URBAN AND RURAL DEVELOPMENT
Urban and Rural Development projects address the needs of communities in ways that improve the
quality of life for citizens. Urban and Rural Development projects aim to improve community food
security and nutritional practices, more thoroughly or efficiently meet medical and basic human needs,
improve public safety and community resilience, and improve access to economic opportunities and
housing. Other aims of Urban and Rural Development projects include seeking to improve student
academic engagement and performance, expand public engagement in local communities, and preserve
cultural or historical integrity of communities. Examples of service activities for these projects include:
supporting homeless shelters, food banks, youth and family service organizations; renovating and
constructing homes for those in need; leading neighborhood and community revitalization projects;
assisting students, parents, and families through tutoring and afterschool programming, and helping to
provide employment counseling and health awareness to community citizens.
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THE APPLICATION PROCESS: AN OVERVIEW
Applying for an AmeriCorps NCCC team is a two-step process. The first step is submitting a Project
Concept Form for review by AmeriCorps NCCC staff. If the concept form is approved, you will be invited
to complete the second step and submit a full application for review by AmeriCorps NCCC staff.
STEP 1: COMPLETE AN AMERICORPS NCCC PROJECT CONCEPT FORM (PCF)
The PCF serves as an opportunity to provide an overview of your organization, to briefly identify the
community need to be addressed and to propose a service project that can help to meet that need.
Regional staff uses the PCF to assess whether the proposed project fits within the scope of NCCC’s five
Project Focus Areas (pg. 3-4). If the concept of the project has been found to meet basic requirements,
you will be invited to complete a full application for an AmeriCorps NCCC team(s).
STEP 2: COMPLETE THE AMERICORPS NCCC SERVICE PROJECT APPLICATION
If you have been invited to apply, a representative from the AmeriCorps NCCC Region that corresponds
with your state will send the full AmeriCorps NCCC Service Project Application to you in a fillable PDF
format. While you are in the process of completing your application, staff members for your NCCC
Region are available to provide you with technical guidance, should you solicit it. Regional contact
information can be found at the end of this instructional guide or on our website. AmeriCorps NCCC has
regional deadlines for application submissions, and are based on the dates for which you are requesting
a team. Deadlines and notifications may be acquired through your Regional Office representative.
PROJECT APPLICATION REVIEW AND APPROVAL
Any project application submitted should outline project goals and activities. All approved Project
Applications must meet the following criteria.
The proposed project:
Meets a compelling community need(s) that falls within the scope of at least one AmeriCorps
NCCC Program Focus Areas.
Has clearly defined outputs and outcomes.
Has a clearly outlined work plan for each team with a weekly and monthly work schedule
that details 40-45 hours of service activities for an AmeriCorps NCCC Team of 8-12 members.
Has a clearly outlined training plan with training that corresponds to the proposed tasks and
any potential safety hazards.
Has identified (at least) one Site Supervisor to provide guidance, weekly planning, supervision
and who will be accessible during the team’s scheduled service time.
Has identified housing that meets NCCC standards.
Demonstrates that the organization will support the safety and security of an NCCC team and
will provide safety and security training to the team during their on-site orientation.
Demonstrates an understanding of service learning and identifies continued
learning/teaching opportunities throughout the service project.
Has outlined a sustainability plan that demonstrates how the work performed by the NCCC
team(s) will be built upon or maintained.
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All Project Applications are evaluated using a standard criteria set and scored using the ratings below.
Rating
Exceeds Criterion
Meets Criterion
Partially Meets
Criterion
Does Not Meet
Criterion
Review Rubric Rating Scale
Description
A high-quality, detailed response that addresses all aspects of the Selection
Criteria and exceeds some. Strengths are substantial and solid. No
weaknesses are identified, or any weakness has a minimal effect on the overall
quality of the response. A high confidence that the proposed activities will
achieve and exceed the anticipated results.
A quality response that addresses most or all aspects of the Selection Criteria.
Strengths are substantial, but do not exceed what is required. No weaknesses
are identified, or any weakness has a minimal effect on the overall quality of
the response. Proposed activities should achieve the anticipated results.
Response addresses some to most aspects of the Selection Criteria, but makes
assumptions and leaves aspects unexplained. Strengths are not significant, and
some weaknesses affect the overall quality of the response, demonstrating
room for improvement. It is unclear how the proposed activities will achieve
all of the anticipated results.
A low-quality or very weak response that does not address most of the
Selection Criteria. Overall response is lacking or inadequate, making
assumptions in key elements. Weakness relating to vague or inaccurate detail
are numerous or significantly outweigh the strengths. There is low or zero
confidence that the proposed activities will achieve the anticipated results.
Each application undergoes multiple reviews by AmeriCorps NCCC staff. Following this review process,
the Region Director reviews and authorizes a list of projects that have been recommended by fellow
staff. The assignment of teams to projects is contingent upon the availability of sufficient funds for the
program, the availability of teams, the frequency of prior team assignment and Campus and National
priorities.
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STEP 1: AMERICORPS NCCC PROJECT CONCEPT FORM INSTRUCTIONS
The Project Concept Form (PCF) serves as an opportunity to provide an overview of your organization, to
briefly identify the community need to be addressed and to propose a service project that can help to
meet that need. AmeriCorps NCCC Regional staff uses the PCF to assess whether the proposed project
fits within the scope of at least one of NCCC’s five Project Focus Areas (pg. 3-4). If the concept of the
project has been found to meet basic requirements, you will be invited to complete a full application for
AmeriCorps NCCC team(s).
Please use the information below for instructions if you are a prospective sponsor interested in applying
for an AmeriCorps NCCC team. The instructions will correspond to each question on the Project Concept
form. Answer each question as fully as possible. During this step, AmeriCorps NCCC Regional Offices
will have the ability to provide you with technical guidance, should you solicit it. If you have any
questions or need additional clarification about any item on the Project Concept Form, please contact
them. A directory of AmeriCorps Regional Office staff contacts is located at the end of this document
on pg. 24 or on our website.
The Project Concept Form consists of the following components.
I.
II.
III.
IV.
V.
VI.
Applicant Information
Project Information
Focus Areas
Narratives
Locations of Service and Team Lodging
Authorize and Submit
APPLICANT INFORMATION
1. Enter your organization name and contact information.
2. When registering your organization, you are required to provide your EIN. Known as the Employer
Identification Number (EIN) or the Federal Tax Identification Number, the EIN is a unique nine-digit
number assigned by the Internal Revenue Service (IRS) to business entities operating in the United
States for the purposes of identification. This number allows CNCS to quickly and accurately identify
all organizations that have received CNCS resources for reporting and tracking purposes.
3. Select all of the organization types that apply to your organization; only organizations that fall within
the types specified here are eligible to apply. If you have questions on what category your
organization may fall into, please contact the representative at your NCCC Regional Office.
4. The Authorized Representative is the organization’s designated representative from your
organization that is legally authorized and certified to submit the Project Concept Paper and the
Application. This person is often referred to as the Project Sponsor and will be the primary person
that AmeriCorps NCCC staff will be communicating with regarding the allocation of NCCC teams and
organizational support to execute the project. They also should be the signatory on this project
application and, if approved, the Sponsor Agreement between AmeriCorps NCCC and your
organization.
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PROJECT INFORMATION
5. Please provide the title of the project for which you are applying. This title will be used to
distinguish between applications if you submit multiple applications to CNCS, so please consider
language that most aptly describes the project.
Indicate the number of teams requested and estimated completion time in weeks. This should be
calculated for a team of 8 to 12 members serving full time 40-45 hours per week. Please keep in
mind that NCCC teams often complete projects quicker than anticipated.
Indicate the proposed start date and whether these dates are fixed (not changeable based on the
nature or timeline of the project) or flexible (able to be reasonably changed). This will allow the
NCCC staff to better arrange logistics and possibly combine the deployments of multiple projects
within a specific time frame.
Indicate the proposed end date and whether these dates are fixed (not changeable based on the
nature or timeline of the project) or flexible (able to be reasonably changed). This will allow the
NCCC staff to better arrange logistics and possibly combine the deployments of multiple projects
within a specific time frame.
Questions 6-7: These questions address funding and labor resources that your organization receives in
relation to this proposed project.
8. If your organization has ever received services of an NCCC team, please enter the number of teams
that your organization received going back 20 years. Additionally, please provide the month and
year that your organization received the last team. This is one criteria used to determine how we
allocate our limited resources.
9. NCCC has effectively partnered with sponsoring organizations that also utilize the services of youth
corps that require fees. Fee-for-Service is defined as an agreement in which a youth or community
service organization pays fees or reimburses costs to an organization in exchange for member or
team support. NCCC does not require a fee but finds value in partnering with organizations that do.
NCCC makes every effort to augment and support these local collaborations as much as possible
when partnering with sponsoring organizations. Please specify if your organization has ever had a
fee-for-service arrangement and, if so, describe how your organization plans to incorporate your
existing partnership with NCCC.
FOCUS AREAS
10. Please select from the drop down the primary area of community need that the project will address;
please refer to pages 3-4 for definitions of each category. You are required to enter a primary area
of community need to be addressed, however, select any secondary area of need only if applicable.
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NARRATIVES
The Narratives section of the Project Concept Form includes 2 topics. Each topic consists of questions
you must answer. When completing the Narrative topics, be sure to:
Clearly label each sub-topic.
Type single spaced within the fields.
Type both the question and answer.
Include activities for the entire span of the project period.
TIP: You may prefer to answer questions first in a word processing document and then paste them into
the fillable PDF format. Avoid using special formatting or tables within the fields. You may however
attach them separately. To remove special formatting, you can utilize the notepad tool or equivalent
that are standard with most home computer systems. If you find that your organization’s responses are
too long for the fields provided, please provide an attachment noting the section and question number
above your continued narrative.
11. Need Narrative
A. Describe the overall mission of your organization
B. Provide a brief overview of the community need
C. Describe how the project and AmeriCorps NCCC team will meet the need
D. Geographic area to be served
E. Demographics of the community
15. Project Design Narrative
Within this field, please describe the following:
A brief description about the service tasks and activities for which your organization is
requesting an NCCC team.
Goals and desired outcomes expected from the involvement of NCCC and how they are related
to the community need and mission of your organization
Briefly describe the accessibility of the work site for persons requiring mobility, vision or hearing
accommodation. Because teams are not assigned to the project when the Project Concept Form
is submitted, accommodations may or may not be required. If a member of the NCCC team has
special accessibility requirements, regional NCCC staff will work with you to arrange
accommodation if the project has been approved and a team is assigned.
Description of lodging arrangements you are exploring for the team. This is where you should
further explain information about disability accommodation, and information on laundry,
kitchen and shower availability that you noted in question #17 – Primary Lodging Site (see
below).
LOCATIONS
16. Primary Location of Service
The Location of Service is the physical location a team will be performing work during their time
with your organization. AmeriCorps NCCC uses this information to ensure the safety of teams and
to report to Congress where teams are performing work across the country (and in their districts).
AmeriCorps NCCC requires a site supervisor to provide technical guidance, training, and instruction
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during the service project. The site supervisor should be an individual who currently has the
technical skills and abilities to perform the tasks at the project site and will train members on
completing the project tasks.
In this section please enter:
The name of your organization
The street address, city, state and zip code where members will be serving, which may or may
not be the location of the organization listed.
Check the box if the project site is accessible for persons requiring mobility, vision or hearing
accommodation. Please describe in more detail accessibility in the Project Design narrative.
Because teams are not assigned to the project when the application is submitted,
accommodations may or may not be needed. If a member of the NCCC team has special
accessibility requirements, regional NCCC staff will work with you to arrange accommodation if
the project has been approved and a team is assigned.
The name of the supervisor that will be providing consistent site supervision throughout the
team’s service on the work site.
The Organizational Title for the Site Supervisor
The Site Supervisor’s phone number; please note the best number to reach this person, a cell
phone is strongly encouraged.
Site Supervisor e-mail
17. Primary Lodging Site
If selected for service, the sponsoring organization is required to provide lodging for the team and,
where applicable, is responsible for any fees associated with the lodging space. Note: Some NCCC
regions may be able to provide lodging for projects on their campus facilities. When available, these
projects must be within a reasonable driving distance of the regional campus. Please inquire with
your regional NCCC Regional staff to learn more about availability and driving distance
requirements.
Accommodations should be responsive to the following requirements:
Adequate space for 8-12 members with separate female and male sleeping facilities
Access to bathroom, shower, and laundry facilities
Availability of cooking and food storage facilities or meals provided by sponsoring organization
Availability of cleaning supplies and basic cleaning tools proportionate to the size of the
accommodations and team. We suggest basic supplies such as toilet paper be available at the
lodging site.
Safety and security of members, their personal belongings, and equipment
Reasonable driving distance (inquire with your region for specifics)
Providing food and/or meals is encouraged, but not required in order to receive a team.
In this section, please enter the lodging arrangements you are exploring for the team. During this
step, lodging does not need to be finalized. Enter as much information as is possible with your
potential lodging. If you need more explanation, please include in the Project Design Narrative
section above.
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Indicate the organization name of the lodging provider
Select the lodging type from the drop-down menu
Select the lodging category from the drop-down menu
Indicate the team’s anticipated arrival and departure date at the lodging site
Indicate the street address, city, state and zip code of the lodging site
Please provide the lodging contact name; this person will be the primary contact for anything
related to the lodging site.
List the phone number and email for the lodging contact person. A cell phone number is
strongly encouraged.
Check this box if beds are provided at this site. Providing beds is not required, however, we are
requesting this information in order to ensure teams are provided with the equipment they will
need.
Check this box if the lodging site can accommodate individuals with mobility, vision or hearing
limitations. Because teams are not assigned to the project when the concept form is
submitted, accommodations may or may not be required. If a member of the NCCC team has
special accessibility requirements, NCCC Regional staff will work with you to arrange reasonable
accommodation at team lodging if the project has been approved and a team is assigned.
Select whether laundry is available on site. If applicable, please include additional information
about fees in the Project Design narrative. If not, please provide the closest laundry facilities
available to the team.
Select whether a full kitchen is available on site for the team to use. Please detail the use and
appliances available in the Project Design narrative. A full kitchen includes a full-sized
refrigerator, a stove and/or oven and a sink large enough to clean dishes. If a full-sized kitchen
is not available on site, please provide the closest kitchen facility available to the team. If a full
kitchen is not available, please note if a microwave and refrigerator or any size is available to
the team.
Select whether showers are available on site. If not, please detail alternate accommodations in
the Project Design narrative.
PROJECT CONCEPT FORM SIGNATURE
Please review the document for completeness and accuracy. Then sign and date the Project Concept
Form. The person who signs the document must be the applicant organization’s authorized
representative who has the authority to commit resources to your organization. An electronic signature
is accepted and encouraged.
SUBMISSION INSTRUCTIONS
Complete and submit this PCF to the NCCC regional program office associated with the state this project
is located. A directory of AmeriCorps NCCC Regional Office staff contacts is located at the end of this
document on pg. 24 or on our website. Upon review of the Project Concept Form, the regional program
office representative will notify the organization of its status. Please do not complete the full
application until instructed to do so. It is preferred that the Project Concept Form be submitted
electronically by email, however it can also be submitted by mail or fax to the regional program office.
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STEP 2: AMERICORPS NCCC SERVICE PROJECT APPLICATION INSTRUCTIONS
If you have been invited to apply, the full AmeriCorps NCCC Service Project Application will be sent to
your organization by the appropriate AmeriCorps NCCC Regional Office for completion. During this step,
Regional Offices will have the ability to provide you with technical guidance, should you solicit it. If you
have any questions or need additional clarification about any item on the application, please contact
them. A directory of AmeriCorps Regional Office staff contacts is located at the end of this document
on pg. 24 or on our website.
These instructions will correspond to each question on the Project Application. Answer each question as
fully as possible.
Note: Some questions are identical to the questions in the Project Concept Form. In these instances,
please cut and paste the same answers or review and edit any necessary changes. There are two
narratives that are similar to the Project Concept Form: Need and Project Design. In the Project
Application, we will be asking for additional information to add to the initial information in these two
narratives.
The Service Project Application consists of the following components.
I.
II.
III.
IV.
V.
VI.
VII.
VIII.
Applicant Information
Project Information
Other information
Locations of Service and Team Lodging
Narratives
Focus Areas and Objectives
Required Attachments
Authorize and Submit
APPLICANT INFORMATION
1. Enter your organization name and contact information.
2. When registering your organization, you are required to provide your EIN. Known as the Employer
Identification Number (EIN) or the Federal Tax Identification Number, the EIN is a unique nine-digit
number assigned by the Internal Revenue Service (IRS) to business entities operating in the United
States for the purposes of identification. This number allows CNCS to quickly and accurately identify
all organizations that have received CNCS resources for reporting and tracking purposes.
3. Select your organization type; only organization types specified here are eligible to apply. If you
have questions on what category your organization may fall into, please contact the representative
at your NCCC Regional Office.
4. The Authorized Representative is the organization’s designated representative from your
organization that is legally authorized and certified to submit the Project Concept Paper and the
Application. This person is often referred to as the Project Sponsor and will be the primary person
that AmeriCorps NCCC staff will be communicating with regarding the allocation of NCCC teams and
12
organizational support to execute the project. They also should be the signatory on this project
application and, if approved, the Sponsor Agreement between AmeriCorps NCCC and your
organization.
5. The Program Director is the organization’s designated representative from your organization that
will be the primary person that AmeriCorps NCCC regional staff will be communicating with
regarding the logistics and oversight to execute the project. This person is often referred to as the
primary Site Supervisor and is the individual in charge of daily activities who serves as a liaison for
the team and their needs. The site supervisor should possess the awareness, experience, and
technical competence to address the project’s safety and technical issues. Enter their contact
information that is most accessible to the staff and team (cell phone instead of office phone, etc.)
PROJECT INFORMATION
6. Please specify the title of the project for which you are applying. This title will be used to distinguish
between applications if you submit multiple applications to CNCS, so please consider the language
that most aptly describes the project.
Indicate the number of teams requested and estimated completion time in weeks. This should be
calculated for a team of 8 to 12 members serving full time 40-45 hours per week.
Indicate the proposed start date and whether these dates are fixed (not changeable based on the
nature or timeline of the project) or flexible (able to be reasonably changed). This will allow the
NCCC staff to better arrange logistics and possibly package the deployments of multiple projects
within a specific time frame.
Indicate the proposed end date and whether these dates are fixed (not changeable based on the
nature or timeline of the project) or flexible (able to be reasonably changed). This will allow the
NCCC staff to better arrange logistics and possibly package the deployments of multiple projects
within a specific time frame.
7. Enter the geographic location(s) where the teams will be serving First select the state or territory
and then provide the corresponding city, county or equivalent. If there are multiple sites, please
note both state and county of all locations. You may list up to three locations.
OTHER
8. This question explains how this project will meet your organizational goals. Please provide at least
one and up to three strategic goals of your organization that are relevant to the project for which
you are applying. In the Project Design Narrative section (below), you will need to link each of these
goals to the community needs addressed by the project.
Questions 9-10: This series of questions address funding and labor resources that your organization
receives in relation to this proposed project.
11. Inclement weather may impact lodging (e.g., high winds if camping) or project tasks (e.g., extreme
cold for outdoor projects) for the team. If you answer “Yes” to this question, you will be asked to
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further explain in question #24 - Lodging site locations or question #26-Project Design Narrative for
project tasks.
12. If you have checked Natural and Other Disasters as either the primary or secondary focus area in
question #35, please chose the project primary disaster type from the following list:
Preparedness – Activities related to creating a resilient nation with the capabilities required
across the whole community to prevent, protect against, mitigate, respond to, and recover from
all hazards.
Readiness – Activities related to the enhancement of capabilities to serve in response, recovery,
mitigation, and preparedness roles.
Mitigation – Activities related to reducing loss of life and property by lessening the impact of
disasters
Response – Activities related to saving lives, protecting property and the environment, and
meeting basic human needs after an incident has occurred
Recovery – Activities related to assisting communities affected by an incident to recover
effectively.
Firefighting – Activities related to the extinguishing of fires. These are response activities
Fire Management – Activities related to the intentional burning, in a controlled and selective
way, grasses, brush, undergrowth, and trees in an area so as to maintain an ecological balance
of species and prevent uncontrolled forest or prairie fires. These are non-response activities.
Questions 13-16: These are specific FEMA Corps project questions that are only relevant to FEMA. Only
FEMA may request FEMA Corps teams. All other applicants requesting traditional NCCC teams can
leave these questions blank.
13. Enter the Presidentially declared disaster number here. If there is another determination, e.g.,
algorithm, base, etc. please enter in Funding Code field and leave the disaster field blank.
14. Please choose ‘high’ if the project needs to be filled within 72 hours. Otherwise chose ‘medium’ or
‘low’ based on tasking priority timing. This will help the campus to assign teams and arrange
logistics of deployment.
15. Based on the project type and the impact of moving the team to a more high profile disaster, please
chose one of the three categories. 1-Unable to Move, 2-Difficult to Move, 3-Easy to Move. This
indicator will help the FEMA Corps Branch and the NCCC campus to more quickly deploy available
resources to shifting priorities when disasters strike.
16. Enter the Service Project Request code. R03 [FEMA Region] - 234 [sequential project number] – MD
[state] – DSA [FQS position] – DSA [team FQS position]
17. Enter the estimated number of volunteers that will be generated during the project based on any
special events as a result of NCCC involvement.
18. Enter the estimated number of volunteers that the team generates that will continue to serve your
organization after the project is over.
19. Enter either yes or no and any supporting information regarding additional background checks
required.
14
Questions 20-22: The safety and security of the NCCC member is of the upmost importance. The three
following questions help the campus determine and mitigate any safety issues that may be present on
the project site. Regions staff are always available to provide consultation and answer questions
regarding any safety and security issues your organization may have. Selection of ‘Yes” responses to any
of these questions does not preclude your organization from receiving an NCCC team. You will,
however, need to further explain any hazards or conditions in the Safety and Security Narrative below.
LOCATIONS
23. Locations of Service
The Location of Service site(s) is the physical location(s) a team will be performing work during their
time with your organization. It is important to accurately document where the team will be
performing their service activities. AmeriCorps NCCC uses this information to ensure the safety of
teams and to report where teams are performing work across the country. AmeriCorps NCCC
requires a site supervisor to provide technical guidance, training, and instruction during the service
project. The site supervisor should be someone who currently has the technical skills and abilities
to perform the tasks at the project site and will train members on completing the project tasks.
Location of Service #1
Indicate the organization name
Indicate the start and end dates of when the team will serve in this location
Indicate if this is the primary site of the project
Check the box if the project site is accessible for persons requiring mobility, vision or hearing
accommodation. Please describe in more detail accessibility in the Project Design narrative.
Because teams are not assigned to the project when the application is submitted,
accommodations may or may not be needed. If a member of the NCCC team has special
accessibility requirements, regional NCCC staff will work with you to arrange accommodation if
the project has been approved and a team is assigned.
Indicate the street address, city, state and zip where members will be serving, which may or
may not be the location of the organization listed.
Indicate the name of the supervisor that will be providing consistent site supervision
throughout the Member's work on the site.
List the Organizational Title for the Site Supervisor
List the Site Supervisor Phone; please note the best number to reach this person, a cell phone is
strongly encouraged.
List the Site Supervisor e-mail
If applicable, for Service Sites #2-4, please follow the above instructions; for projects with more than
three site locations, please attach a PDF with the information required above for each additional
site location.
24. Lodging Sites
If selected for service, the sponsoring organization is required to provide lodging for the team and,
where applicable, is responsible for any fees associated with the lodging space.
15
Note: Some NCCC regions may be able to provide lodging for projects on their campus facilities.
When available, these projects must be within a reasonable driving distance of the regional
campus. Please inquire with your regional NCCC Regional staff to learn more about availability and
driving distance requirements.
Accommodations should be responsive to the following requirements:
Adequate space for 8-12 members with separate female and male sleeping facilities
Access to bathroom, shower, and laundry facilities
Availability of cooking and food storage facilities or meals provided by sponsoring organization
Availability of cleaning supplies and basic cleaning tools proportionate to the size of the
accommodations and team. We suggest basic supplies such as toilet paper be available at the
lodging site.
Safety and security of members, their personal belongings, and equipment
Reasonable driving distance (inquire with your region for specifics)
Providing food and/or meals is encouraged, but not required in order to receive a team.
Lodging Site #1
In this section, list the locations and contact information of all of the anticipated lodging facilities
that will be provided to the AmeriCorps NCCC team(s).
Indicate the organization name of the lodging provider
Select the lodging type from the drop-down menu
Select the lodging category from the drop-down menu
Indicate the team’s anticipated arrival and departure date at the lodging site
Indicate the street address, city, state and zip of the lodging site
Please provide the lodging contact name; this person will be the primary contact for anything
related to the lodging site.
List the phone number and email for the lodging contact person. A cell phone number is
strongly encouraged
Check this box if beds are provided at this site. Providing beds is not required, however, we are
requesting this information in order to ensure teams are provided with the equipment they will
need
Check this box if the lodging site can accommodate individuals with mobility, vision or hearing
limitations. Because teams are not assigned to the project when the concept form is
submitted, accommodations may or may not be required. If a member of the NCCC team has
special accessibility requirements, NCCC Regional staff will work with you to arrange reasonable
accommodation at team lodging if the project has been approved and a team is assigned.
Please include additional information about reasonable accommodation in the dialog box
below.
Select whether laundry is available on site. If applicable, please include additional information
about fees in the dialog box below. If laundry is not available on site, please provide the closest
laundry facility available to the team.
Select whether a kitchen is available on site for the team to use. Please detail the use and
appliances available in the dialog box below. A full kitchen includes a full-sized refrigerator, a
stove and/or oven and a sink large enough to clean dishes. If a full-sized kitchen is not available
on site, please provide the closest kitchen facility available to the team. If a full kitchen is not
available, please note if a microwave and refrigerator or any size is available to the team. Also
16
note if any meals are provided and on which days on site. Please note that meals provided by
the sponsor are encouraged, but not required.
Select whether showers are available on site; in the dialog box below. Detail the expectations
on use of the shower (e.g., cost, scheduling, and location). If showers are not available on site,
please detail an alternate accommodation.
Further Describe Team Lodging Accommodations - Additional Information
In this dialog box, please provide information regarding indoor, camping options and safety and
security of the proposed lodging facility.
INDOOR LODGING
A. If you checked yes on any of the Lodging Site questions, please provide additional
information here, e.g., # of beds provided, # of meals provided and when, etc.
B. Provide a descriptive overview of the lodging
C. Number and type of rooms along with any furniture available (if applicable)
D. Any appliances available to the team for use (stove, refrigerator, microwave, etc.)
E. Additional lodging information and rules of use of the facility
CAMPING - Teams performing camping projects must have access to a substantial structure or
facility in the event of excessive inclement weather or for emergency evacuation (e.g., excessive
rain/hot or cold temperatures, tornadoes, hurricanes, bug/mosquito seasons, etc.)
A. If you checked yes on any of the Lodging Site questions, please provide additional detail
here (e.g., # of meals provided, accessibility, etc.)
B. Use of bathroom and shower facilities; consider associated costs, scheduling, location etc.
C. Cooking location and expectation for food preparation
D. Expectations for food storage (including dry and cold storage)
E. Overview on what items your organization can provide e.g. electricity on site, screened
tents, canvas tents, propane, ice, indoor kitchen facility, etc.
F. Details on weather conditions and considerations when camping during the proposed time
of year
G. Detailed information about the indoor location for the team to retreat to in case of
inclement or emergency weather
H. Additional information about the camping location and use of the facility
LODGING SAFETY AND SECURITY
A. A description of how the team’s belongings will be secure during the project
B. Any precautions members should take while traveling & living in the community
C. Local emergency response procedures
D. Distance to the closest medical facilities
E. The community in which team will be housed; please consider cultural sensitivity, rules
and expectations on use of space and additional information you would like us to know
about the use of space in your community
F. Any other information related to lodging safety and security
If applicable, for Lodging Sites #2 and #3, please follow the above instructions; for
projects with more than three Lodging Sites, please attach a PDF with the
information required above for each additional site location.
17
NARRATIVES
The Narratives section of the Project Applications includes 10 topics. Each topic consists of
questions you are required to answer in order to complete this application. When completing the
Narrative topics, be sure to
Type single spaced within the fields.
Type both the question and answer.
Include activities for the entire span of the project period.
TIP: You may prefer to answer questions first in a word processing document and then paste them
into the fillable PDF format. Avoid using special formatting or tables within the fields. You may
however attach them separately.
25. Need Narrative
Describe the overall mission of your agency to include a brief history and how the mission is fulfilled
by your various programs. Please describe unmet community need(s) you propose to address using
AmeriCorps NCCC resources; use supportive data and include:
A. Describe the overall mission of your organization
B. Detailed overview of the community need
C. Describe how the project and AmeriCorps NCCC team will meet the need
D. Geographic area to be served
E. Demographics of the community
F. Community beneficiaries
G. Anticipated community benefit(s)
26. Project Design Narrative
Within this field, please describe the following:
The specific service tasks and activities that the team will perform.
Goals and desired outcomes expected from the involvement of NCCC and how they are related
to the community need and mission of your organization
A detailed work plan. The project must engage all team members in service throughout the
duration of the project a minimum of 40-45 hours a week. The work plan is an essential part of
demonstrating how the organization will provide the required hours of service and should
include the following:
Specific tasks to be accomplished and how the team will complete the tasks
Estimated number of members required to complete each work task
Estimated amount of time in hours to complete each task
A priority list of tasks. This will be helpful to for NCCC supervision and if the team is
called away to disaster before their full service assignment is completed.
An additional work plan of tasks in the event the team completes the assigned work early or
unexpected circumstances prevent implementation of the original plan
Describe the accessibility of the work site for persons requiring mobility, vision or hearing
accommodation. Because teams are not assigned to the project when the Project Concept
Form is submitted, accommodations may or may not be required. If a member of the NCCC
team has special accessibility requirements, regional NCCC staff will work with you to arrange
accommodation if the project has been approved and a team is assigned.
18
An explanation of any work permits and other legal permissions specific to the project that are
needed and secured. If not secured, please explain the timeline to accomplish this
requirement.
An inclement weather work plan that covers at least 25% of your proposed project dates that
details alternative indoor work options.
May include service opportunities with other organizations such as eligible non-profits,
schools or local government agencies that has indoor work.
Please note, the primary organization will continue to be responsible for ensuring the
team is able to complete 40-45 hours of work that week.
Attach a calendar that outlines the schedule of work on a weekly and/or monthly basis. A
calendar template with instructions can be found in Appendix B If you are not able to provide a
comprehensive work calendar, please provide a sample work calendar; if selected for a team,
an updated work calendar will be required.
27. Project Management Narrative
AmeriCorps NCCC members come to our program with various abilities and skills, we often refer to
our members as “generalists.” Given members have a wide range of skills and abilities that may not
specifically relate to your project, please describe below how you will equip members to properly
prepare and perform the tasks outlined in the Project Design section. Please detail the following:
A. Pre-project Preparation: Describe any recommended readings, training materials, websites,
paperwork, or additional trainings you would like a team to receive prior to arriving on site.
B. On-Site Orientation: Please provide a comprehensive on-site orientation agenda. Please
include in the agenda: an overview of your organization and the project, introductions of the
team to the staff of the sponsoring organization(s), tour of the work site(s) and the
community, safety and security and a lodging use overview.
C. Training Plan: Provide a training plan outlining the training that members will receive during
the project. This plan should include tool training, safety training, and project specific
training (e.g., positive youth development, tree identification, roofing instruction, etc.). If a
variety of tasks have been proposed in the work plan, the training plan should identify
how/when members will be trained to perform the task. The training template with
instructions can be found in Appendix C.
28. Recruitment Narrative
AmeriCorps NCCC strives to continually share our mission with others. We hope to discover
communities who may benefit from NCCC services and to educate young adults in communities
nationwide about service opportunities with NCCC. In this section, briefly describe opportunities in
your community to publicize the partnership and work completed with your organization and NCCC:
A. Public Recognition: Identify opportunities to publicly recognize the partnership with NCCC
if selected for service. Possible examples include earned media, social media, community
events, inclusion in organizational publications, press releases, inviting elected officials to
serve with the team, etc.
19
B. Public Outreach: Detail opportunities that exist in your community to promote AmeriCorps
NCCC and the service completed on this project
C. Potential Local Recruiting Partners: List any schools, universities or community
organizations near you that may be interested in having an NCCC representative come and
speak with young adults or youth about serving in the AmeriCorps NCCC program.
29. Member Development Narrative
Service learning is an integral part of the NCCC program; it fosters leadership development as the
members gain a deeper understanding about what they are doing and why it is important to the
community. Service learning allows teams to make the connection between their acts of service
and what this means to your specific community. Organizations are encouraged to continue
building on a team’s understanding of the service they are providing and its importance to the
community throughout the service project; this teaching and learning extends beyond orientation
and training (previously documented in the Project Management section).
Use this section to detail the following:
A. Service Learning Opportunities: Describe the service learning opportunities available to a
team to help AmeriCorps NCCC members enhance their overall knowledge and
understanding about what they are doing and why it is important to the community; this
may include guest speakers, information about a community’s larger social issues, events
related to the culture and people served, discussions about environmental impact, city
council meetings, community activities and events, etc.
B. Skills, Competencies, and Certifications: List the skills, competencies, and/or certifications
members may acquire during this project that will help them to complete the activities and
tasks outlined in the Project Design section.
C. Life and Career Planning Resources: Please describe any life and career planning resources
that may be available to Corps Members to assist them in better understanding the work of
your organization (examples include job shadowing, informational interviews, brown bag
lunch discussions on working in the field of your organization, etc.)
30. Strengthening Communities Narrative
AmeriCorps NCCC was designed to assist organizations on a short term basis. Your organization may
apply for multiple teams at a time or additional applications for consecutive teams over a longer
time frame, depending on the community need. Organizations are expected to have a plan for
maintaining the work completed by NCCC and/or have identified steps to secure an alternative
workforce if continual labor is needed.
Please describe your sustainability plan, including detailed descriptions of the following:
A. Anticipated outputs and outcomes (also called results, impacts and accomplishments),
which define results that will have taken place because of the proposed project
B. If and how NCCC will increase the organization’s capacity to engage more volunteers. Refer
back to questions #17-18.
20
C. How your organization will continue to maintain and build upon NCCC’s work after the team
has left
D. AmeriCorps NCCC is a short term national service resource and is not intended for extended
support. NCCC resources will not allocated to community organizations longer than 60
weeks. If your organization has received the benefits of NCCC teams for 30 or more weeks
without a gap of 3 years or more, please describe your plan to reduce and ultimately satisfy
the need for NCCC support.
31. Organizational Capacity Narrative
Detail how your organization has the capacity to manage a team that is part of a federal national
service program. Be sure to include answers to the following:
A. What programs, activities or services are you currently using to meet the need?
B. Describe your current volunteer program and average number of weekly volunteers, if
applicable.
C. How are community partners or current volunteers engaged in meeting the proposed
community need, if applicable?
D. How do you see an NCCC team complementing your current volunteer program and how
will your organization incorporate the use of an NCCC team alongside organization
volunteers (including other national service participants).
E. Describe opportunities for NCCC members to assist with coordinating or leading volunteers.
32. Executive Summary Narrative
In 2,000 characters or less, please write an executive summary addressing the following criteria
using the template below:
• The mission of your organization
• A description of the proposed project goal(s)
A description explaining the project and its tasks
A brief explanation of how this project will address a pressing community need
• including how the community will benefit from the project
Executive Summary Template: [Organization Name]’s mission is [Mission Statement]. AmeriCorps
NCCC has partnered with [Organization] to [enter project goal(s)]. Members will contribute to the
goals of the project by performing activities such as [enter tasks]. The project is expected to benefit
[describe how the community will benefit].
If a team is assigned to the project, this summary may be used for internal and external purposes
such as reports, websites, media materials or communication to external stakeholders. The
submission of this application authorizes that use.
33. Safety and Security Narrative
The safety and security of NCCC members is of the upmost importance for the AmeriCorps NCCC
program. The site supervisor should be present with the team daily and should possess the
awareness, experience, and technical competence to address the project’s safety and technical
issues. NCCC Regional staff are always available to provide consultation and answer questions
around safety and security issues.
21
Please provide an overview of any safety considerations an NCCC team may need to be aware of
when serving on this project; include plans to mitigate any associated risks. Include the following:
A. If you answered yes to questions #20-22 above, please explain the hazards or conditions.
B. If members will be utilizing tools, please describe safety concerns and how tool safety will
be addressed during the project. (Be sure to include this in your training plan.)
C. Any environmental conditions that might be present at any work site (poison ivy, allergens,
extreme weather conditions, etc.)
D. Any recommended or required immunizations
E. Identify local medical facilities, including address, telephone, hours of operation, and
distance from the project site and team lodging.
F. Describe how medical emergencies would be handled during the project.
G. Any other safety considerations
34. Tools and Equipment Narrative
In this section, please list:
A. Equipment, tools, and quantity of equipment your organization will provide.
B. Equipment, tools and quantity of equipment requested from NCCC to supplement your
supply. AmeriCorps NCCC has limited access to tools and cannot not guarantee the
availability of requested items; applicants are encouraged to provide tools and equipment
for the service project.
C. Access to fax, copy machine, internet/WIFI to the team for official team business and
project-related purposes.
D. Appropriate personal protective equipment; respirators, gloves, goggles, etc. should always
be available to the team as needed. NCCC regional staff and the project sponsor must
ensure this availability.
FOCUS AREAS AND OBJECTIVES
35. Select from the drop down the primary area of community need that the project will address; please
refer to pages 3-4 for definitions of each category. You are required to enter the Primary area of
community need but only enter any secondary area of need if applicable.
36. Select all the project objectives from the options provided that apply to the project. If you do not
see an objective that is applicable, enter a descriptor in the ‘Other Objectives’ field. Selection of
more than one project objective will not increase the chances of the project being selected for
award. Please be as accurate as possible when providing this information.
37. Please select all that apply
38. Please select all that apply.
APPLICATION ATTACHMENT LIST
Supporting documentation is a critical component of the project application. The supporting materials
requested below will help NCCC staff develop a better understanding of the proposed project during the
application review process. Please include the following documentation when submitting your
application.
22
REQUIRED ATTACHMENTS
1. On-Site Orientation: Please attach a comprehensive on-site orientation agenda to your application.
This should include an overview of your organization and the project, introductions of the team to
the staff of the sponsoring organization(s), tour of the work site(s) and the community, safety and
security and a lodging use overview.
2. Training Plan: Please attach a training plan outlining the training that members will receive during
the project. This plan should include tool training, safety training, and project specific training (e.g.,
positive youth development, tree identification, roofing instruction, etc.). If a variety of tasks have
been proposed in the work plan, the training plan should identify how/when members will be
trained to perform the task.
3. Project Work Plan Calendar: Include a project work plan that outlines the schedule of work. The
schedule will assist in planning where a team will perform work, which staff member will work with
the team, the assigned task(s) for each work day and the number of members it will take to
complete each task. The work plan calendar is an essential part of demonstrating how the
organization will provide the required 40-45 hours of work for the team.
OPTIONAL ATTACHMENTS
1. Lodging Photos: Please provide at least one photo of the proposed team lodging. Strong
applications often include photos of team living quarters, kitchen and bath facilities and storage
areas for personal belongings.
PROJECT APPLICATION SIGNATURE
Please review the document for completeness and the elimination of any errors. Then review the
‘Important Notices’ section at the end of the application. Sign and date the Service Project Application.
The person who signs the document must be the applicant organization’s authorized representative
who has the authority to commit resources to your organization. An electronic signature is accepted
and encouraged.
SUBMISSION INSTRUCTIONS
Complete and submit the Service Project Application to the same regional program office
representative that received the Project Concept Form. A directory of AmeriCorps Regional Office staff
contacts is located at the end of this document on pg. 24 and on our website. AmeriCorps NCCC has
regional deadlines for application submissions, and are based on the dates for which you are
requesting a team but generally should be submitted at least 4 months prior to the preferred start date
of the project. Please include any required or supplemental attachments. It is preferred that the
Service Project Application be submitted electronically by email but can also be submitted by mail or
fax to the regional program office representative. Once received, they will notify you to discuss the
next steps of the process.
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Appendix A
AmeriCorps NCCC Regional Campuses AmeriCorps NCCC has five regional campuses
located in Perry Point, MD; Denver, CO; Sacramento, CA; Vicksburg, MS; and Vinton, IA.
These campuses are the hubs from which AmeriCorps NCCC operates and deploys corps
members to service projects around the country. Each campus serves as a headquarters for
its multi-state region and can lodge and feed its entire regional corps, which ranges in size
from 150 to 500 members. The staff at the campuses support both the corps members and
project sponsors as they engage in service activities.
NCCC Atlantic Region
6726 Youngstown Ave
Dundalk, MD 21222
Tel: 443-503-8569 or 8500
Fax: 443-923-4899
E-mail: [email protected]
States Served: CT, DC, DE, MA, MD, ME, NH, NJ, NY, PA, PR, RI, USVI, VT
NCCC Southwest Region
Denver Federal Center
W. 6th Ave. & Kipling St.
Building 53, Suite E1319
Lakewood, CO 80225-0167
Tel: 303-844-7400
Fax: 303-844-7410
E-mail: [email protected]
States Served: AR, AZ, CO, KS, MO, NM, OK, TX
NCCC Pacific Region
3427 Laurel Street
Sacramento, CA 95652
Tel: 916-640-0310
Fax: 916-640-0318
E-mail: [email protected]
States Served: AK, CA, HI, ID, MT, NV, OR, UT, WA, WY, Pacific Territories
NCCC North Central Region
1004 G Avenue
Vinton, IA 52349
Tel: 319-472-9664
Fax: 319-472-9666
E-mail: [email protected]
States Served: IA, IL, IN, MI, MN, NE, ND, OH, SD, WI
NCCC Southern Region
2715 Confederate Avenue
Vicksburg, MS 39180
Tel: 601-630-4040
Fax: 601-630-4071
E-mail: [email protected]
States Served: AL, FL, GA, KY, LA, MS, NC, SC, TN, VA, WV
24
AmeriCorps National Civilian Community Corps (NCCC)
Project Concept Form (PCF)
Applicant Information
1.
Organization Name:
Mailing Address:
City:
State:
Office Telephone:
Ext:
2.
EIN:
3.
Organization type:
Select all that apply
4.
ZIP:
Community or Faith-Based
Federal Government
Indian Tribe
Local Government or Municipality
National Non-Profit
National or State Park
School
State Government
Authorized Representative:
Title:
Phone Number:
Ext:
Email Address:
Project Information
5.
Project Title:
Number of Teams Requested:
1
Estimated Completion 1
Time (Weeks):
Proposed Start Date:
Start Date is: Fixed
or flexible
Proposed End Date:
End Date is: Fixed
or flexible
Page 2
Other
6.
Is your organization currently funded wholly or in part by the
Corporation for National and Community Service?
No
If 'Yes,' is the proposed project funded by an AmeriCorps State and
National grant or any AmeriCorps VISTA resources?
No
If you answered 'Yes' to either of the above questions, please provide detailed information
concerning the funding source and utilization of those funds.
7.
Will the proposed service replace any of your organization's current or
projected staff or contracted labor?
No
8.
Has your organization previously sponsored a NCCC team?
No
If 'Yes' how many teams have served with your organization?
1
If 'Yes' when did a team most recently serve with your organization?
9.
Has your organization ever had a "Fee for Service" arrangement with
a Youth Corps or Conservation Corps program?
NCCC has effectively been used in past projects to augment and
support existing Youth Corps partnerships with organizations. Please
describe how your plan to utilize NCCC will incorporate your existing
partnership with the "Fee for Service" corps.
No
Page 3
Focus Areas
Project Focus Areas
10.
Primary area of community need:
Secondary area of community need:
Narratives
11.
Need
12.
Project Design
Page 4
Locations
13.
Primary Location of Service
Organization:
Accessible for people
with disabilities?
Street Address:
Street Address (Line 2):
City:
State:
Zip+4:
Site Supervisor Name:
Site Supervisor Title:
Site Supervisor Phone:
Ext:
Site Supervisor Email:
14.
Primary Lodging Site
Beds
Provided?
Lodging Provider:
Type of Lodging:
Accessible for people
with disabilities?
Lodging Category:
Laundry
on Site?
Arrival Date:
Kitchen
on Site?
Departure Date:
Street Address:
Microwave
and Fridge?
Street Address (Line 2):
Showers
on Site?
City:
State:
Zip+4:
Lodging Contact Name:
Lodging Contact Phone:
Ext:
Email:
SIGNATURE
The Project Concept Form must be signed by a representative of the sponsoring
organization. An electronic signature will be accepted.
Project Sponsor Signature
Date
AmeriCorps National Civilian Community Corps (NCCC)
Service Project Application
Applicant Information
1.
Organization Name:
Mailing Address:
City:
State:
Office Telephone:
Ext:
2.
EIN:
3.
Organization type:
Select all that apply
ZIP:
Community or Faith-Based
Federal Government
Indian Tribe
Local Government or Municipality
National Non-Profit
National or State Park
School
State Government
4. Authorized Representative:
Title:
Phone Number:
Ext:
Email Address:
5.
Program Director:
Title:
Phone Number:
Ext:
Email Address:
Project Information
6.
Project Title:
Number of Teams Requested:
1
Estimated Completion 1
Time (Weeks):
Proposed Start Date:
Start Date is: Fixed
or flexible
Proposed End Date:
End Date is: Fixed
or flexible
Page 2
Areas Affected by the Project
7.
State or Territory
City or County
Area Affected #1:
Area Affected #2:
Area Affected #3:
Other
8.
Organization goals relevant to the project.
First Goal:
Second Goal:
Third Goal:
9a.
Is your organization currently funded wholly or in part by the
Corporation for National and Community Service?
No
9b.
If 'Yes,' is the proposed project funded by an AmeriCorps State and
National grant or any AmeriCorps VISTA resources?
No
9c.
If you answered 'Yes' to either of the above questions, please provide detailed information
concerning the funding source and utilization of those funds.
10.
Will the proposed service replace any of your organization's current or
projected staff or contracted labor?
No
Page 3
Other
11.
Could this project be impacted by inclement weather?
12.
Disaster Type:
13.
Disaster Number:
14.
Request Priority:
Low
15.
Team Mobility:
Low
16.
Partner Project Code:
No
Recovery
or Funding Code:
17.
Number of episodic volunteers generated by AmeriCorps Members:
18.
Number of ongoing volunteers generated by AmeriCorps Members:
19.
The Corporation for National and Community Service conducts criminal history checks on all
members which consists of a fingerprint-based FBI criminal history search and a check of the
National Sex Offender Public Website (NSOPW.gov).
Will your organization conduct additional background checks?
No
If yes, please specify what additional background checks are required and how these
requirements will be satisfied. If an organization requires additional background checks for
AmeriCorps NCCC Members, the organization is responsible for fees associated with the
background checks and completing the background checks prior to or at the start of the
project.
20.
Does this project include possible exposure of members to asbestos,
lead paint, hazardous waste, or any other safety hazards?
No
21.
Will members be required to work with potentially hazardous chemicals
such as solvents, acids, pesticides, herbicides, adhesives, etc.?
No
22.
Are there any Health conditions that might preclude an NCCC member
from fully participating based on project location or project conditions?
No
Page 4
Locations
23.
Location of Service #1
Organization:
Projected Service Start Date:
Primary
Site?
Projected Service End Date:
Accessible for people
with disabilities?
Street Address:
Street Address (Line 2):
City:
State:
Zip+4:
Site Supervisor Name:
Site Supervisor Title:
Site Supervisor Phone:
Ext:
Site Supervisor Email:
Location of Service #2
Organization:
Projected Service Start Date:
Primary
Site?
Projected Service End Date:
Accessible for people
with disabilities?
Street Address:
Street Address (Line 2):
City:
State:
Site Supervisor Name:
Site Supervisor Title:
Site Supervisor Phone:
Site Supervisor Email:
Ext:
Zip+4:
Page 5
Locations
Location of Service #3
Organization:
Projected Service Start Date:
Primary
Site?
Projected Service End Date:
Accessible for people
with disabilities?
Street Address:
Street Address (Line 2):
City:
State:
Zip+4:
Site Supervisor Name:
Site Supervisor Title:
Site Supervisor Phone:
Ext:
Site Supervisor Email:
Location of Service #4
Organization:
Projected Service Start Date:
Primary
Site?
Projected Service End Date:
Accessible for people
with disabilities?
Street Address:
Street Address (Line 2):
City:
State:
Zip+4:
Site Supervisor Name:
Site Supervisor Title:
Site Supervisor Phone:
Ext:
Site Supervisor Email:
For projects with more than four site locations, please attach a PDF with the
information required above for each additional site location.
Page 6
Locations
24.
Lodging Site #1
Beds
Provided?
Lodging Provider:
Type of Lodging:
Accessible for people
with disabilities?
Lodging Category:
Laundry
on Site?
Arrival Date:
Kitchen
on Site?
Departure Date:
Street Address:
Microwave
and Fridge?
Street Address (Line 2):
Showers
on Site?
Zip+4:
State:
City:
Lodging Contact Name:
Lodging Contact Phone:
Ext:
Email:
Further Describe Team Lodging Accommodations
Lodging Site #2
Beds
Provided?
Lodging Provider:
Accessible for people
with disabilities?
Type of Lodging:
Laundry
on Site?
Lodging Category:
Arrival Date:
Kitchen
on Site?
Departure Date:
Street Address:
Microwave
and Fridge?
Street Address (Line 2):
Showers
on Site?
State:
City:
Lodging Contact Name:
Lodging Contact Phone:
Ext:
Email:
Zip+4:
Page 7
Locations
Further Describe Team Lodging Accommodations
Lodging Site #3
Beds
Provided?
Lodging Provider:
Type of Lodging:
Accessible for people
with disabilities?
Lodging Category:
Laundry
on Site?
Arrival Date:
Kitchen
on Site?
Departure Date:
Street Address:
Microwave
and Fridge?
Street Address (Line 2):
Showers
on Site?
State:
City:
Zip+4:
Lodging Contact Name:
Lodging Contact Phone:
Ext:
Email:
Further Describe Team Lodging Accommodations
For projects with more than three lodging locations, please attach a PDF with the
information required above for each additional lodging location.
Page 8
Narratives
25.
Need
Page 9
Narratives
26.
Project Design
Page 10
Narratives
27.
Project Management
Page 11
Narratives
28.
Recruitment
29.
Member Development
Page 12
Narratives
30.
Strengthening Communities
31.
Organizational Capacity
Page 13
Narratives
32.
33.
Executive Summary
Safety and Security
Page 14
Narratives
34.
Tools and Equipment
Page 15
Focus Areas and Objectives
35.
Project Focus Areas
Primary area of community need:
Secondary area of community need:
36.
Project Objectives
Access to Care
At-Risk Ecosystems
Awareness and Stewardship
Capacity Building and Leverage
Community Support
Disaster Assistance Provided
Education Support
Energy Efficiency
Engaging Participants
Environmental Conservation
Financial Literacy
Housing
Inclusion of People with Disabilities
Infrastructure Improvement
Other Healthy Futures
Populations Assisted and Engaged
Public Safety
Other Objectives:
37.
Target Populations
Population #1:
Population #2:
Population #3:
38.
Project Characteristics
Characteristic #1:
Characteristic #2:
Characteristic #3:
Individuals experiencing homelessness
AmeriCorps NCCC
Application Review and Agreement
IMPORTANT NOTICES
ADDITIONAL PAPERWORK REQUIREMENTS: If the Project Application is approved
and teams perform the service project, the project sponsor will be required to review and sign
two additional documents: the Sponsor Agreement and the Project Completion Report.
Sponsoring organizations will also be asked to complete a survey to capture their evaluation of
their partnership with the NCCC.
•
SPONSOR AGREEMENT: Once the Project Application has been approved, a formal
agreement (called a Sponsor Agreement) will be executed between the sponsor
organization and the NCCC, which will specify the roles, responsibilities, and
contributions of both parties. Teams cannot begin work on the project until this
agreement is approved by signature by both parties.
•
PROJECT COMPLETION REPORT: After the project is completed the project
sponsor will be asked to review and approve the NCCC Project Completion Report, and
return it to the regional Program Office within five (5) days of receipt.
•
SURVEYS: Project sponsors who have used the services of teams will be asked to
participate in surveys designed to provide the NCCC with feedback that will inform
continuous improvement of services.
DISASTER/FIRE RESPONSE: NCCC members and staff are part of the Federal Emergency
Management Agency (FEMA) and American Red Cross National Disaster Response Network.
In addition, the NCCC assists local, state, and national forest services with wildfire suppression.
Potential project sponsors should note that in the event of a natural disaster or homeland security
crisis, members may be recalled from projects to serve as part of the relief efforts. This could
result in a decrease in the number of members assigned to your project, a delay in the
deployment of a team, or cancellation of a project.
LIABILITY AND WORKERS' COMPENSATION CLAIMS: The Corporation for National
and Community Service (Corporation) is a self-insured federal agency. Consequently, members
and federal employees of the NCCC are covered by the provisions of the Federal Tort Claims
Act (liability claims) and the Federal Employees Compensation Act (workers' compensation
claims) 42 U. S. C. §12620 (b) & (c). Accordingly, the United States Government will assume
responsibility for any injuries or property damage caused by the negligence of a member or an
employee who was acting within the scope of his/her employment. Similarly, any on-the-job
injuries received by an NCCC member or federal employee will be processed by the Corporation
and the Department of Labor.
AmeriCorps NCCC
Application Review and Agreement
WAIVERS: No member of an AmeriCorps NCCC Team (including any Corps Member or Team
Leader) shall sign any document provided by the Project Sponsor or any representative or
employee of the Project Sponsor, including but not limited to: liability waivers, hold harmless
agreements, indemnification agreements, or employment-related documents. In the event that a
member of an AmeriCorps NCCC Team signs a document provided by the Project Sponsor or
any representative or employee of the Project Sponsor, the signature on any such document shall
have no force or effect of law
NON-DISCRIMINATION: A Project Sponsor receiving teams from AmeriCorps NCCC
will comply with all federal statutes, including the National and Community Service Act of
1990, as amended, relating to nondiscrimination, which includes nondiscrimination on the basis
of race, color, national origin, sex, age, disability, and in most instances, religion. CNCS
prohibits all forms of discrimination based on race, color, national origin, gender, age, religion,
sexual orientation, disability, gender identity or expression, political affiliation, marital or
parental status, or military service. All programs administered by, or receiving Federal assistance
from CNCS, must be free from all forms of harassment. Project sponsors will be required to sign
an
assurance
of
non-discrimination
as
part
of
the
Sponsor
Agreement.
SERVICE PROJECT LIMITATIONS: In the course of performing a service project,
members cannot engage in any project assignments that involves direct fundraising, financial
transactions, preparation of a grant application to the Corporation or to any other Federal agency,
or any political or inherently religious activities
SIGNATURE
The Service Project Application must be signed by a representative of the sponsoring
organization. An electronic signature will be accepted.
Project Sponsor Signature
Date
| File Type | application/pdf |
| Author | Kelley, Crystal |
| File Modified | 2016-04-11 |
| File Created | 2015-12-14 |