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SUD Allies Host Site Intent to Apply 2021-2022
Thank you for your interest in hosting Substance Use Disorder (SUD) Allies AmeriCorps members. Please complete the following short survey to inform us of your intent to apply.
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1.
Organization Name
(Required.)
*
2.
Primary Contact
(Required.)
Name
Title
Email Address
Phone Number
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3.
How many SUD Allies AmeriCorps members do you intend to apply for?
(Required.)
*
4.
Does your organization have experience hosting AmeriCorps members?
(Required.)
Yes
No
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5.
Provide a brief description of the role you envision for the SUD Allies AmeriCorps member.
(Required.)
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6.
Would you like to receive technical assistance during the application process? (Technical assistance may include: calls to review the RFA, the application, and/or the proposed position description).
If yes, we will reach out to the contact person listed above.
(Required.)
Yes
No
7.
Please indicate if you have any other questions or concerns in the space below:
Current Progress,
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