Please refer to the Guide to Partnering for more information about Climate Impact Corps.

Site Name: *

AmeriCorps service typically takes place at non-profit, government, and/or educational institutions. Restrictions or additional policies may apply for AmeriCorps service at sites that are faith based/religious or for-profit entities. Please indicate whether the criteria below apply to your site.

Faith-based/religious

For-profit

Street Address *

Address Line 2

City *

State *

Zip Code *

Minnesota County *

County: *

Organization Information & Community Need

Briefly describe your organization's mission and vision. *

0/300 words

Help us better understand the population and community that the AmeriCorps member(s) will be serving through your organization. Please include information such as geographic reach, participant demographics, community need, and/or specific populations served.

As an AmeriCorps program, Climate Impact Corps is included in the Biden-Harris Administration's Justice40 Initiative, which aims to deliver 40 percent of the overall benefits of climate, clean energy, affordable and sustainable housing, clean water and other investments to disadvantaged communities that are marginalized, overburdened and underserved. Please use the Climate and Economic Justice Screening Tool to note any target communities or regions served by your organization. *

0/300 words

Director Information

First Name *

Last Name *

Position Title *

Email Address *

Phone Number *

Site Supervisor Information

All AmeriCorps programs require a Site Supervisor to provide onsite support and supervision for each member placed. If you do not know who that is at this moment, please select “designate at a later time” and a staff member will work with you to identify this person. Otherwise, select "Enter Site Supervisor Info" and please fill in the information below.

Designate a Site Supervisor: *

Enter Site Supervisor Information

Designate at a later time

First Name *

Last Name *

Position Title *

Email Address *

Phone Number *

Recruitment Contact Information

Ampact staff lead and facilitate the interview and selection process for AmeriCorps members. Partner organizations play an essential and active role in member recruitment by collaborating with Ampact staff to provide referrals and recruit prospective AmeriCorps members from their community and networks.

Please identify a recruitment contact who will lead recruitment efforts at your site and serve as a point of contact for Ampact staff for recruitment-related communication and meetings.

Who will be your Recruitment Contact? *

Same as Principal/Director

Same as Site Supervisor

Someone Else

First Name *

Last Name *

Position Title *

Email Address *

Phone Number *

In 3 sentences or less, what are you looking for in an AmeriCorps member? If you are referring a particular candidate for the position, please list their name and contact information here. (300 word limit) *

0/300 words

AmeriCorps Member Request

AmeriCorps members with Climate Impact Corps provide capacity-building services to sites as Climate Impact Project Coordinators. Climate Impact Project Coordinators support climate-related projects at their sites and build the capacity of sites to increase their reach, effectiveness, and/or efficiency.

Sites indicate their specific requests for climate-related projects for AmeriCorps member support in the grid below. Once awarded, sites complete a pre- and post-capacity assessment that aligns with the Minnesota Climate Action Framework. Additionally, sites and members develop a unique service plan at the beginning of the service term to outline how the member(s) will support their site.

AmeriCorps members with Climate Impact Corps are referred to as Climate Impact Project Coordinators. Indicate the total number of Climate Impact Project Coordinators requested by your site: *

Indicate the commitment levels of Climate Impact Project Coordinators requested by your organization. We consider organizational requests as well as candidate availability when placing members. *

Full-time (40 hours/week)

Part-time (25 hours/week)

Climate Impact Project Coordinators provide capacity building services to support sites in implementing the Minnesota Climate Action Framework and/or Tribal Nation Cimate Action Framework. Please indicate the climate priority area(s) for which you are requesting Climate Impact Corps member(s) to support below.

For the climate priority areas listed in each row, indicate the capacity building domain(s) in each column that you anticipate the member(s) supporting. If you do not anticipate member(s) supporting a particular climate priority area, please select "N/A" in the righthand column for that row.

The information collected here helps Climate Impact Corps understand how your site envisions AmeriCorps member service enhancing your capacity. This informs our site selection and member placement processes, assists us in creating member training plans, and also provides valuable insights for members to develop effective service plans.

For complete definitions and examples of each capacity building domain and climate priority area, please refer to this Climate Impact Corps Definitions and Examples document. *

	Community Engagement, Communication, and Outreach	Data Collection, Research, and Analysis	Process Improvement	Volunteer Management and Mobilization	Workforce Development	Coordination of Site-Specific Projects Related to the Needs of the Community and Sector	N/A
Clean Transportation	Community Engagement, Communication, and Outreach	Data Collection, Research, and Analysis	Process Improvement	Volunteer Management and Mobilization	Workforce Development	Coordination of Site-Specific Projects Related to the Needs of the Community and Sector	N/A
Climate-Smart Natural and Working Lands	Community Engagement, Communication, and Outreach	Data Collection, Research, and Analysis	Process Improvement	Volunteer Management and Mobilization	Workforce Development	Coordination of Site-Specific Projects Related to the Needs of the Community and Sector	N/A
Resilient Communities	Community Engagement, Communication, and Outreach	Data Collection, Research, and Analysis	Process Improvement	Volunteer Management and Mobilization	Workforce Development	Coordination of Site-Specific Projects Related to the Needs of the Community and Sector	N/A
Clean Energy and Efficient Buildings	Community Engagement, Communication, and Outreach	Data Collection, Research, and Analysis	Process Improvement	Volunteer Management and Mobilization	Workforce Development	Coordination of Site-Specific Projects Related to the Needs of the Community and Sector	N/A
Healthy Lives and Communities	Community Engagement, Communication, and Outreach	Data Collection, Research, and Analysis	Process Improvement	Volunteer Management and Mobilization	Workforce Development	Coordination of Site-Specific Projects Related to the Needs of the Community and Sector	N/A
Clean Economy	Community Engagement, Communication, and Outreach	Data Collection, Research, and Analysis	Process Improvement	Volunteer Management and Mobilization	Workforce Development	Coordination of Site-Specific Projects Related to the Needs of the Community and Sector	N/A
Tribal Nation Climate Action Goal	Community Engagement, Communication, and Outreach	Data Collection, Research, and Analysis	Process Improvement	Volunteer Management and Mobilization	Workforce Development	Coordination of Site-Specific Projects Related to the Needs of the Community and Sector	N/A

If you indicated "Tribal Nation Climate Action Plan Goal" above, please list the name(s) of the tribal nation(s) and provide a brief description of the goal(s).

0/300 words

Climate Impact Corps is particularly interested in some specific direct service activities due to targeted funding. Please indicate which of the following activities you expect Climate Impact Corps members to participate in during the 2024-25 year. Please check all that apply or indicate "none of the above". *

Inventory and/or plant community trees

Develop or implement Emerald Ash Borer management plans

Construct or maintain gravel bed nurseries

Support residential energy audits and/or energy conservation measures

None of the above

How will AmeriCorps service build the capacity of, but NOT replace or duplicate, the work of existing staff? *

0/300 words

AmeriCorps policy requires that AmeriCorps members serve at a physical site location, even if service activities are delivered virtually. Does your site have a physical location for AmeriCorps members to conduct their service? *

Yes

No

Sites must provide Climate Impact Corps members access to a computer/device with high-speed internet beginning on their first day of service to complete training and other program requirements. How will your organization ensure this expectation is met? Do you have any concerns about your organization's ability to meet this expectation due to the availability of devices, organization/agency policy, or other factors? *

0/300 words

Will AmeriCorps members at your organization do any driving as part of their service (i.e. between site locations, within the community)? Members are not allowed to drive clients, children, or hazardous products (chemicals, power tools, etc.). Members under the age of 18 are not allowed to drive as part of their service. *

All AmeriCorps members expected or required to drive their own cars or company-provided vehicles are required to complete a motor vehicle check for Ampact that must be approved before they can begin driving as part of their service.

Are AmeriCorps members at your organization expected to drive an organization-provided vehicle as part of their service? *

Please list any requirements your organization has for AmeriCorps members placed at your site. Please include as much detail as possible so Ampact staff can inform candidates of site-based requirements during the interview and selection process. *

0/300 words

Please list any other considerations or preferences related to your member request.

0/300 words

Site Agreement Information

All Ampact site partners must sign a site agreement outlining the partnership between the site and the program. Our site agreement requires the signature of someone who is authorized to enter into an agreement on behalf of your site or agency.

Click here if the contact to sign the Climate Impact Corps Site Agreement is someone other than the Director.

First Name *

Last Name *

Email Address *

Phone Number *

Review & Submit

Please provide the information of the person completing this site application below.

Review the form before clicking the "Submit" button below to submit this application. The Principal/Director listed above will receive a copy of this application via email.

First Name *

Last Name *

Phone Number *

Email Address *

Position Title *