NHC Chicago 2019-2020 Host Site Intent to Apply Thank you for your interest in hosting National Health Corps Chicago AmeriCorps members. Please complete the following short survey to inform us of your intent to apply. OK Question Title * 1. Organization Name OK Question Title * 2. Primary Contact Name Title Email Address Phone Number OK Question Title * 3. How many NHC members do you intend to apply for? OK Question Title * 4. Does your organization have experience hosting AmeriCorps members? Yes No OK DONE