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Community Outreach Program Facilitator Application

Expectations: Please initial by each checkbox to signify your understanding.

_____Strong applicants will have previous experience of at least one semester as a Community

Outreach volunteer.

_____Facilitators will be expected to provide proof of auto insurance, driver license, and complete

van training with a member of the Center staff.

_____Facilitators will be expected to commit at least one full semester of participation in facilitating

weekly Outreach projects at assigned agency.

_____Facilitators will agree to be reliable, knowledgable, professional, responsible, and personable

representatives of the Center for Leadership & Social Change.

_____Facilitators will commit to active participation in monthly Community Outreach meetings and

trainings.

Basic Information

For which semester are you applying (circle one) Spring Summer Fall
Today’s date: ______Year in School: ______
Name: ______
Major: ______Expected Graduation (Month/Yr): ______
Local Address: ______

Phone Number(s): ______

E-mail: ______
T-shirt size: ______FSU CARD# (Last 8 numbers): ______
Van Training & Insurance Requirements
*Please note: All students selected for Community Outreach Facilitator positions are expected to
be van trained in order to transport volunteers from campus to service sites in Center vans.

Do you have a valid driver license AND auto insurance (circle one)? Yes No

*Please note: All drivers of Center vans must be insured under an auto insurance policy and provide proof of coverage.

Are you willing to go through training to drive a Center van? ______


Community Interest

Which community need areas are you most interested in working with?

(ex. animals, children, seniors, health services, arts & culture, environment, hunger, homelessness, etc.)

______

Is there a specific agency that you would like to work with? (ex. Second Harvest, PAEC, Grace Mission, etc.)

______

How did you first hear about the Community Outreach Program?

______

Which days/times of the week are you anticipating being available to facilitate?

______

Questions/Prompts

Answer the following questions/prompts on a separate sheet of paper and attach it to this application:

r  Please name Community Outreach projects with which you have previously volunteered.

r  Why does the Community Outreach Facilitator position interest you?

r  What skills, strengths, experience, etc. would you bring to this position?

r  What do you hope to gain or learn from this experience?

r  Tell us about your leadership/community involvement experience while at FSU.

Submit your completed application to the Center for Leadership and Social Change to the attention of Morgan Matchett at . Applications can also be dropped off at the front desk of the Center. After submitting applications, you will be contacted by a representative from the Center for an interview. Contact Morgan Matchett if you have any questions.

100 S. Woodward Avenue

Phone: 850 644-3342

Fax: 850 644-3362

thecenter.fsu.edu