Site Application

Thank you for your interest in Recovery Corps, we are looking forward to reviewing your application for potential partnership. For questions, please contact us at sites@ampact.us.

Please visit this page to review the Recovery Corps Guide to Partnering for more information about the program. All sites are required to review and acknowledge their review at the end of this application before submitting.

Site Name: *

Street Address *

Address Line 2

City *

State *

Zip Code *

Minnesota County *

Illinois County *

Virginia County *

County: *

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

Type of Organization/Site (check only one) *

Organization Information & Community Need

Briefly describe your organization's mission and vision. *

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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. *

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. This is typically a staff member of the site and cannot be another AmeriCorps member. This position requires a time commitment of 6-9 hours (monthly) of coaching and support per member and up to 5 hours of required training. To learn more about the role of Site Supervisor, please refer to the Site Supervisor Description section in the Guide to Partnering (linked above),

If you do not know who your Site Supervisor is at this time, 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 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 *

What characteristics 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. *

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AmeriCorps Member Request

There are two positions that AmeriCorps members can serve in with Recovery Corps: Recovery Navigator or Recovery Project Coordinator. Please consider the items below when determining your member request for the 2025-2026 program year. If you have any questions related to your member request, please contact sites@ampact.us.

Participant need and availability
Site schedule and space availability
Availability and capacity of the Site Supervisor (we estimate that Site Supervisors designate 6-9 hours (monthly) of support per member per month.
The Guide to Partnering (linked above) provides detailed information on considerations for making a member request.

Indicate the total number of Recovery Navigators requested by your organization: *

Indicate the commitment levels of Recovery Navigators requested by your organization. We consider organizational requests as well as the availability of the candidate when placing members. *

Full-time (40 hours/week)

Part-time (25 hours/week)

Recovery Navigators are expected to meet weekly with a minimum of 20 clients on a recurring basis. How will you ensure the caseload expectations of Recovery Navigators are consistently met? *

0/300 words

Indicate the total number of Recovery Project Coordinators requested by your organization: *

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

Full-time (40 hours/week)

Part-time (25 hours/week)

Recovery Project Coordinators provide capacity building services to their sites. Please indicate the recovery priority area(s) for which you are requesting Recovery Corps member(s) to support below. For the recovery 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 recovery priority area, please select "N/A" in the righthand column for that row.

The information collected here helps Recovery 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 recovery priority area, please refer to this Recovery 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
Peer Support	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
Substance Use Prevention	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
Research, Data, and Evidence-Based Practices	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
Harm Reduction	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
Policy and Systems Change	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
Technology Integration	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
Community-Led Initiatives	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
Targeted Support Programs	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
Collaborations and Partnerships	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

Please describe the activities the requested AmeriCorps member(s) will perform with your organization. How will AmeriCorps service build the capacity of, but NOT replace or duplicate, the work of existing staff? *

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Please provide details about the projects you want your member(s) to work on and how the presence of a Recovery Corps member(s) will influence your organization’s overall capacity to achieve its mission. In 3-4 sentences provide specific examples. *

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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 and space for AmeriCorps members to conduct their service? *

Yes

No

Sites must provide Recovery Corps members access to a computer/device with high-speed internet and a web camera beginning on their first day of service to complete training and other program requirements. Will your organization be able to fulfill this requirement? If no, please provide more information. *

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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 participants, 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. *

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

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Client Need & Demographics

Estimated number of clients served by your organization annually that would be eligible to work with a Recovery Navigator: *

Percentage of clients receiving services from your organization who are in each category below:

% American Indian or Alaska Native *

% Asian *

% Black or African American *

% Hispanic or Latino *

% Native Hawaiian or other Pacific Islander *

% Two or More Races *

% White *

Site Agreement Information

All Ampact site partners must sign a site agreement outlining the partnership between the site and the program. This agreement is required to be signed at the organizational level (not site level) and is also signed by Ampact. Please provide a contact for us to send the site agreement.

If your site is not part of a larger district or agency, please provide a contact who has authority to sign contracts on behalf of your site.

First Name *

Last Name *

Email Address *

Phone Number *

Position Title *

Site Fee

For Sites in MN Only: Funding decisions for Recovery Corps for the 2025-2026 Program Year are still being finalized. As a result, there may be a site fee required for participation in the program during this period. We will continue to communicate with all current and potential site partners as decisions around site fees are finalized.

HIDDEN FROM FORM FOR NOW

Click here if the billing contact for the site fee associated with the Recovery Project Coordinator is someone other than the Director.

First Name *

Last Name *

Email Address *

Phone Number *

Position Title *

Review & Submit

I have read the Recovery Corps Guide to Partnering and understand and agree to the expectations and responsibilities of site partnership with Ampact. *

Yes

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. If you have questions please contact us at sites@ampact.us. The Principal/Director listed above will receive a copy of this application via email.

First Name *

Last Name *

Phone Number *

Email Address *

Position Title *