Application for Re-Member Program Supervisor Position
Program Supervisor
APPLICATION
2019
APPLICATION FOR RE-MEMBER PROGRAM SUPERVISOR POSITION
NAME:
ADDRESS:
E-MAIL:
AGE:
BIRTH DATE:
MONTHS/DATES OF AVAILABILITY:
(note: first-time PMs are typically scheduled for 3-6 weeks)
PHONE:
BEST TIME TO BE REACHED:
DRIVERS LICENSE NUMBER:
ISSUING STATE:
DATE SUBMITTED:
BRIEFLY RESPOND TO THE FOLLOWING QUESTIONS (2-3 paragraphs)
1. Please list the dates of when you volunteered at Re-Member and the projects you worked on while volunteering.
2. Please provide a short summary of why you want to be a Program Supervisor and what you hope to gain from this experience.
3. What are three unique attributes or skills that you could bring to Re-member as a PS?
4. How would you best describe Re-Member’s involvement and intentions on the reservation?
5. Do you perceive yourself as a “people person?” What is your comfort level in providing leadership and receiving direction?
PLEASE RESPOND TO AT LEAST ONE OF THE FOLLOWING QUESTIONS
1. Describe one social issue affecting the reservation and how would you go about conveying that information to volunteers.
2. Describe a specific experience at Re-Member or on the reservation and how it has affected your personal/professional life.
TRADE SKILLS SURVEY
Please BOLD your level of ability and describe any experience you have in each area.
Trade skills are NOT a requirement or an expectation of applicants.
Refer to the following scaleas you complete this assessment.
SKILLS ASSESSMENT SCALE(6) I make, or have made, my living performing this trade.
(5) This is an avocation of mine. I am familiar with all the tools of this trade and am skilled.
(4) This is an avocation of mine. I am familiar with most tools, and have some skills.
(3) I am a handy person and capable of performing this trade well, but I’m not an expert.
(2) I know the difference between the basic tools of the trade and can do the job with help and supervision from a knowledgeable person.
(1) I am capable of staying out of the way and assisting.
Re-Member’s carpentry work consists of building: Steps/decks, wheelchair ramps, trailer skirting, outhouses, and bunkbeds.
General Carpentry654321
Experience:
Gardening654321
Experience:
●Are you comfortable driving a van with volunteers?YESNO
Vans: 6 passenger to 15 passenger
●Are you comfortable driving a vehicle pulling a trailer?YESNO
This includes backing up, hooking up and unhooking
●Do you have any First Aid Training?YESNO
If yes please indicate training above under "other" (above)
and when you were last certified