This questionnaire will be used to help us understand your preferences and needs when considering host site placement and planning for trainings. Your response to these questions will have no bearing on your application for the Summer Reads VISTA position.

Summer Reads Interview Checklist 2015

Minnesota Literacy Council

The following information should be explained to the VISTA applicant during the interview. Please have the applicant sign the bottom to indicate that he or she has received and understands this information.

8 week, full-time commitment (Greater Minnesota: June 8-August 2; Twin Cities Metro: June 15-August 9; Outreach Specialists: June 3-August 11 (10 weeks))

No other employment allowed during theterm of VISTA service

No part-time or full-time enrollment in an educational institution allowed without prior approval

No personal, sick or vacation days allowed during term of VISTA service

Biweekly living allowance of approximately $450 (pre-tax), depending on the countyof service (Federal taxes are taken out but state taxes are not)

$1,212 Education Award (can be used within seven years for future tuition or to repay qualified student loans) OR $230 cash stipend awarded upon successful completion of service

Transportation reimbursement of $0.575 per mile by Minnesota Literacy Council for travel between placement sites and Minnesota Literacy Council sponsored trainings & events

Federal student loan forbearance while serving and interest paid by CNCS after successful completion of service.

Thorough background check conducted. We run national, state and county background checks as well as a national sex offender history check.

Pre-Service Orientation (Greater Minnesota: June 8; Twin Cities Metro: June 15-16),travel expenses paid by CNCS

In-service trainings throughout the term of service, typically every other Friday (dates TBA)

Public assistance benefits are unaffected by serving, but the living stipend is considered income

______

Applicant Name (printed)Date

______

Applicant Signature

Please describe your working style. Do you prefer to work in a more structured setting or one where you work more independently? How much supervision do you prefer?

A select number of Summer Reads VISTAs are chosen to additionally work on a Capstone Project. Capstone projects are applied research projects that a group of VISTAs work on throughout the summer. These projects are intended to benefit all sites and advance the field of children’s literacy. Last summer, a Capstone Project group created a rubric to evaluate educational iPad apps and websites and then made a website of the top-rated apps and websites in various categories.

Would you be interested in participating in the Capstone Project? __ Yes __ No

If yes, do you have any particular interests in the literacy field that you would be interested in pursuing? (e.g., digital literacy, family involvement, immigrant and refugee populations, etc.)

How technologically proficient and comfortable are you? Do you have experience with excel, online forums and blogs, and uploading images and videos?

Will you regularly have access to internet? __ Yes __ No

Please list any additional language skills and your level of proficiency

Language :______Proficiency:______

Language :______Proficiency:______

What will be your home address during service? If unknown, please specify with as much detail as possible (city, neighborhood, etc).

What type of transportation would you rely on this summer?

____ Car____ Public transportation____ Bike____ Other, please explain:

Do you have any dietary restrictions?

Emergency contact info

Name:Relationship:Phone:

*Twin Cities Metro applicants only: Metro-area VISTAs are placed in St. Paul, Minneapolis, eastern suburbs and western suburbs. Please indicate your top two preferences for placement location.

____ St. Paul____ Minneapolis____Eastern suburbs____Western suburbs

Is there anything else you would like us to know?