Southwest Conservation Corps

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Veterans Green Corps Corpsmember Application

Name
FirstLast
Address
Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry
Email
Home phone
Cell phone
Date of Birth (mm/dd/yyyy)*
Gender*
Indicate whether you are Hispanic or Latino
Indicate your race(s): Check one or more boxes.
- American Indian or Alaska Native
- Asian
- Black or African American
- Native Hawaiian or Other Pacific Islander
- White
How did you hear about the Southwest Conservation Corps?
- Friend
- Family
- Newspaper
- Coolworks.com
- Backdoorjobs.com
- Veterans Green Jobs
- Job Fair
- Other website
- Other
What dates are you available to work?
In which region do you prefer to be based?*
What season(s) are you applying for?
- Winter (Jan-March)
- Spring (March-May)
- Summer (June-August)
- Fall (September-November)
Have you read the job description for the position to which you are applying?
Have you worked for a youth/conservation corps before?
If yes, which corps?
Do you have a DD214, Certificate of Release or Discharge from Active Duty? An other than honorable discharge does not necessarily bar you from participating in this service opportunity.
- Yes
- No
Military Unit
Service dates
Military Occupational Skill
Rank
Where did you serve?
Have you ever been convicted of a crime? SCC will conduct background checks. A criminal background does not necessarily bar you from participating in this service opportunity.*
If yes, please explain.
Are you able to work legally in the U.S.?
Are you able to lift up to 50 lbs and hike up to 15 miles? If not, please honestly declare your present ability.*
Are you able to work 8-10 hours a day on projects that require bending, digging and repetative motions?*
If you have any health or physical limitations that restrict your ability to perform any of these functions please explain and include what we can do to help.
Do you have any dietary limitations, restrictions or allergies that we can accommodate?
References: Please list two references. Do not list friends or family members, work or school reference is preferred. Please include their name, contact information and relationship to you.
Please check your highest education level
Employment History: Please list, in chronological order, your last three employers. Please include the following for each job you list: position title, name of employer, phone number, name of supervisor, wage earned and reason for leaving. *
Tell us about a challenging experience that required a significant commitment from you in order to complete successfully.*
Tell us about your experience in the outdoors. Do you have experience camping? Backpacking?
What experience do you have working with a team and what type of goals were you trying to accomplish?*
The work SCC completes is very physically demanding. Please tell us what expereince you have doing physical labor. If you have never done physical labor, please talk about other physical activities or sports in which you participate on a regular basis.
SCC supports you with job recommendations, job placements and we can serve as a reference for any job you apply to if you successfully complete our program. What are your goals after SCC, and how do we fit into your future plans?
Why should SCC hire you? What positive qualities will you bring to your crew?
I have read the information about the Southwest Conservation Corps and I understand that this opportunity will involve hard physical work, living in the outdoors, working as a member of a team and participating in an education program. If offered a position with SCC, I agree to refrain from the use of alcohol and drugs during my entire period of involvement. If participating in AmeriCorps, I understand that a background check will be conducted on me and my acceptance into this program is contingent upon your review of this background check. I realize that I have an opportunity to review and challenge the factual accuracy of the results of a background check before any action is taken to exclude me from this program. I certify that all statements made in this application are true, correct and complete to the best of my knowledge, and are made in good faith. I understand that misinformation or omission of information could result in disqualification and/or termination as an SCC Corpsmember. *
- Yes
- No
Applicants Signature*
Post Title

Empowering individuals to positively impact their lives, their communities and the environment.

Ancestral Lands
Acoma, NM
(970) 259-8607
Four Corners
701 Camino del Rio Suite 101
Durango, CO 81301
(970) 259-8607
Los Valles
7710 West Hwy 50
Salida, CO 81201
(719) 539-2438
Sonoran Desert
1376 W St Mary Rd
Tucson, AZ 85745
(520) 884-5550

AmeriCorps

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