Youth in Action AmeriCorps (YiA)
2011-2012 Project Requirements
Youth in Action AmeriCorps is pleased to offer the opportunity for your site to become our partner in
providing services to Coconino County. The new 2011-2012 funding cycle requires potential mentor
sites to apply for an AmeriCorps Member to serve at their agencies. Service Assignment Project
requirements will be outlined to help potential sites complete this application.
Please read the requirements, guidelines and application carefully.
CURRENT SITES MUST HAVE REQUIRED 2010-2011 DOCUMENTATION SUBMITTED BEFORE
Applications are due no later than 5 p.m. on Monday June 13, 2011. YiA will screen site
applications and provide members for those sites that best meet project goals and community
Successful applicants will be notified no later than July 5, 2011.
2011-2012 Youth in Action Project
Overview of Requirements and Guidelines
1. YiA AmeriCorps Members will develop, lead, deliver and evaluate a project that fills a
substantiated community need. The focus areas for these projects will be in community
improvement, education, environmental issues and public safety. Projects need to be self-
sustaining and continue to meet the community needs on or before the current three year
funding cycle which ends in 2012. Sites must reapply each year describing how an
AmeriCorps member will continue to serve on current project proposals, or to propose a
new project that will also need to be completed on or before the end of the current three-
year grant funding cycle.
2. The Governor’s Office is requiring all AmeriCorps programs to start their projects by
Monday October 3rd, 2011 and finish by September 30, 2012. This means that all YiA
Mentors Sites will have to hire and start their members by October 1st, 2011. There
are no exceptions.
3. The YiA AmeriCorps Member will have opportunities to experience personal, professional
and community growth. This will be achieved through training and guidance provided by
the mentor site and the Youth in Action Esprit de Corps Member Service and Professional
4. Mentor Sites will need to provide documentation of partnership suitability and the
commitment to fulfill AmeriCorps requirements. Please submit a copy of current liability
insurance with this application.
a. Minimum Requirement Guidelines: Commercial General Liability: with minimum
limits of $1,000,000 per occurrence, and an unimpaired products and completed
operations aggregate limit and general aggregate minimum limit of $2,000,000.
Coverage shall be at least as broad as the Insurance Service Office, Inc. Form
CG25031185, used on an Occurrence basis, and endorsed to add the State of Arizona,
Arizona Board of Regents/Northern Arizona University as an Additional Insured with
reference to this contract. The policy shall include coverage for: Bodily Injury; Broad
Form Property Damage (including completed operations); Personal Injury; Blanket
Contractual Liability; Products and Completed Operations, and this coverage shall
extend for one year past acceptance, cancellation or termination of the services or work
defined in this contract; Fire Legal Liability.
5. AmeriCorps funding requires partners to provide a cash match that does not come from
federal funding sources. Cash match is a requirement of the grant. The cash match is
used to fund the delivery of an AmeriCorps project for Coconino County. AmeriCorps sites
will also be required to provide in-kind matching documentation on a quarterly basis
while AmeriCorps member is serving at their site.
6. YiA AmeriCorps is in the process of being funded to place 14 full-time (1700 hours), 19
part-time (900 hours) 17 quarter-time (450 hours ) living stipend members at mentor sites.
The application is available at our web site under “How to Apply”, “Apply to Become an AmeriCorps
Mentor Site”, http://www.nau.edu/americorps. We strongly recommend that you visit our YiA
AmeriCorps web site at http://www.nau.edu/americorps and the National AmeriCorps web site at
http://www.nationalservice.org/. These sites will help give you insight and information about
AmeriCorps. It is an honor that requires much effort to be a part of an organization that “Makes a
Difference” both locally and nationally.
Youth in Action AmeriCorps
2011-2012 Mentor Site Application
General Directions: Clicking on the gray box will allow you to type in your specific information. The
gray text box will expand to hold the text that you provide. There is not a limitation on the text entered
unless otherwise specified in each section.
Main Phone Line:
Director’s Email address:
Site Designated Mentor:
Mentor’s Direct Line:
Mentor’s Email address:
Other Organizational Information:
Computer: Macintosh PC
Software: Microsoft Word Excel PowerPoint Adobe Acrobat Reader
Capable of opening, reading and completing attachments and forms on the computer
Specific Requested Information
1. Mentor Sites will need to provide documentation of partnership suitability and the commitment
to fulfill AmeriCorps requirements. By checking the information requested and turning in this
application to our project you are stating that you understand and will provide the information
listed below. If you have any questions or need clarification about the information below
Brian K. Francis – YiA Project Director at: email@example.com
or call his direct line at 928-523-2199
Note: By double-clicking on each box, you are indicating that your site is willing to
provide the necessary documentation for suitability and compliance with all YiA
AmeriCorps site requirements.
Review and understand the Mentor Site/ Member Agreements that each site will need to
agree to and sign once a member is placed with the Mentor Site.
Draft copies are located on our website at www.nau.edu/americorps – click on the “How to
Apply”, “Apply to Become a Mentor Site”, “2011-2012 Mentor Site and/or Member Agreement
Drafts.” You can also request to receive the documents as email attachments from:
Mentor sites understand and acknowledge that AmeriCorps members may not engage
in activities that replace or substitute for an employee at the mentor site.
Supply YiA with this application, a Current Copy of Agency Liability Insurance (specific
requirements are outlined in the draft agreement above.
The Governor’s Office is requiring all AmeriCorps programs to start their projects by
October 3rd, 2011 and finish by September 30, 2012. Mentors Sites will have their
members hired and started on October 1st, 2011 and will have all members completed
by September 30, 2012. There are no exceptions.
YiA AmeriCorps will pay for and complete all background checks to comply with changing
AmeriCorps guidelines. This will be an FBI fingerprinted background check. If your site
requires an additional background check it will be the site’s responsibility to complete.
Attend Mentor Training provided by YiA. Mentor Training sessions will be scheduled for
Review and approve Member Time Sheets.
Complete and submit Quarterly Reports and In-kind Cash Match documentation.
Complete and review with your member the Member Evaluation portion of the Quarterly
Provide timely feedback to the YiA staff on Member progress and concerns.
Share concerns and suggestions for program delivery and YiA staff support of Mentor sites.
Promote AmeriCorps in a positive way to the community at large.
Release and support AmeriCorps member for Esprit de Corps opportunities
and the Governor’s Conference on Service and Volunteerism at the end of July, 2012.
Willingness to provide Esprit de Corps opportunities at mentor site for all members.
Attend Esprit de Corps events with your member whenever possible.
Keep contact information current.
2. AmeriCorps funding requires partners to provide a cash match that does not come from
federal funding sources. Cash match is a requirement of the grant. The cash match is used to
fund the delivery of an AmeriCorps project for Coconino County.
By double clicking and checking this box, you are indicating that your agency has cash match
that (1) does not come from federal funding sources, or (2) comes from a federal source that
allows its funds to be used for this purpose.
Cash match amounts will be due upon placement of a member.
Full-Time Member –1700 service hours – Cash Match $6,000.00
Part-Time Member – 900 service hours – Cash Match $3,600.00
Quarter-Time Member – 450 service hours – Cash Match $2,400.00
YiA AmeriCorps has received funding to place 14 full-time (1700 hours), 19 part-time (900
hours) 17 quarter-time (450 hours) living stipend members.
Please indicate your member preference and the number of members requested (every effort
will be made to fulfill your request, but there are no guarantees):
Full Time Member – Cash Match $6,000.00
Part Time Member – Cash Match $3,600.00
Quarter Time Member – Cash Match $2,400.00
3. YiA AmeriCorps Members will develop, lead, deliver and evaluate a Service Assignment
Project that fills a substantiated community need. The focus areas for these projects will be in
community improvement, environmental issues, education, and public safety. Service
Assignment projects need to be self-sustaining and continue to meet the community need on
or before the current three year funding cycle ends in 2012. Sites will reapply each year
describing how the AmeriCorps member will continue to serve on current project proposals or
to propose a new project that will also need to be completed on or before the end of the
current three-year grant funding cycle.
Substantiated Community Need: This is a need in the community that has been documented
through reports, surveys, studies or agency records, that has either not been delivered to the
community or needs a new creative approach that could help in meeting this need. Improved
literacy skills for high school students could be an example of a need in the community, based
on academic achievement scores.
Community Improvement: This area focuses on working to improve the quality of life in the
Education: This area focuses on providing tutoring that develops reading appreciation and
reading skills improvement.
Environmental: This area focuses on community education about sustainability and
environmental impact issues.
Public Safety: This area focuses on addressing the safety of individuals as well as
communities with an emphasis on preventative safety projects.
Self-Sustaining: The service assignment project will continue to meet the community need
without AmeriCorps funds.
Youth in Action AmeriCorps
2011-2012 Member Service Assignment Description:
Please describe in detail the service assignment project that an AmeriCorps member will be working
on at your site. The information provided in this form is used to recruit AmeriCorps members for your
specific service assignment(s). Include descriptions of how the member will develop, deliver, lead,
evaluate and apply for funding that will lead to the sustainability of the project. If it is a project that
has already been started describe how the member will be incorporated into the project and continue
to develop, deliver, lead, evaluate and pursue sustainability. Please include any details that you think
apply. Creativity is encouraged. Sites applying for multiple members performing different
assignments must complete service assignment forms for each unique and different
The service assignment project must be very specific about the time frame during which
members will complete their term of service. Members may complete the bulk of their assignment
at different times during the calendar year. For example: Members who are serving at school sites
can do the bulk of their hours during the school year. They will need to post hours during the summer
in order to receive their stipend. Members with positions where the bulk of their hours are during the
summer will need to post hours during the other months in order to receive a stipend. There are often
many questions about how and when members can serve at mentor sites. If you have questions
please contact: Brian K. Francis – YiA Project Director at:
firstname.lastname@example.org or call his direct line at 928-523-2199
If you have more than one service assignment description please copy and paste the
information below for all additional service descriptions you wish to include in this
application. If the description is the same for all requested members please indicate that this
project will be completed by the number of members you are requesting.
Service Assignment Project
General Directions: The information provided below is used to recruit AmeriCorps members for your
specific service assignment(s). You must complete this form for every service assignment you
Clicking on a gray text box will allow you to type in your specific information. The gray box will expand to hold the text that
you provide. Indicates Required Field
Name of organization:
Location of organization:
Website of organization:
Brief description of organization:
Title of AmeriCorps service assignment:
What is the primary focus of this service assignment project?
Community Improvement Education Public Safety Environment
AmeriCorps Service Assignment Description: Provide the AmeriCorps service assignment
description. This includes the most important duties, responsibilities, and expectations required of the
AmeriCorps member to complete the service assignment. Please list the most important
characteristics of the service assignment in numerical order. You may add more numbers if needed.
AmeriCorps Member Qualifications: Provide the AmeriCorps applicant qualifications and/or
preferences. These may include: languages spoken, physical capabilities, computer skills, availability
during weekends and/or evenings, previous related experience, familiarity with multicultural
environments, strong communication skills, comfortable with public speaking, etc . Please list the
most important qualifications of the service assignment in numerical order. You may add more
numbers if needed.
4. The YiA AmeriCorps Member will have opportunities to experience personal, professional and
community growth. This will be achieved through training and guidance provided by the
mentor site and the Youth in Action Esprit de Corps (EDC) Member Service and Professional
The mentor site will support the member in completion of the EDC requirement. Members are
also required to attend the Arizona Governor’s Conference on Service and Volunteerism held
at the end of July held in Flagstaff. Nationwide, AmeriCorps members are asked to participate
in National days of service. This year’s EDC focus will be asking our members to participate in
activities surrounding these days.
Members will be encouraged to support their fellow mentor sites by volunteering for events
upon approval of site. This can count toward member hours but will not fulfill EDC
Describe how the site will mentor, train and supervise the member. Include what type of site
orientation the member will receive when they join the site.
Please share any additional comments, concerns, or information about your site’s service
Please list any attachments you are including in your application here:
Please submit application as a “Word Document Attachment” to:
email@example.com by 5 p.m. Monday, June 13, 2011.
The Youth in Action AmeriCorps staff thanks you for your time and effort in completing this
application. If you have questions please contact:
Brian K. Francis - Project Director