Homes for All VISTA Site Continuation
2017-2018
DateSubmitted: Click here to enter a date.
AGENCY INFORMATION:
Legal Name: Click here to enter text.
Address: Click here to enter text.
EIN: Click here to enter text.
Legal Status of Agency:☐501(c)3 Charitable Non-Profit☐ Government Agency☐ Other
MISSION/PURPOSE OF AGENCY
Describe the core programs of your agency. In other words, what does your organization do to fulfill its mission? Click here to enter text.
Give a short 2-3 sentence description of your intended VISTA project. Click here to enter text.
CONTACT INFORMATION
Agency Director: Click here to enter text.
Director Phone Number: Click here to enter text.
Email Address: Click here to enter text.
Contact Person: Click here to enter text.
Contact Email Address:Click here to enter text.
Proposed VISTA Supervisor: Click here to enter text.
Email:Click here to enter text.
Phone Number: Click here to enter text.
ORGANIZATION INFORMATION
# of Full-time Staff: Click here to enter text.
# of Part-time Staff: Click here to enter text.
# of Active Community Volunteers: Click here to enter text.
Annual Budget: Click here to enter text.
Age of Organization: Click here to enter text.
VISTA PROJECT FOCUS AREA
☐ Economic Opportunity (Financial literacy, housing, employment)
☐ Military Families
☐ Healthy Futures (Sustainable agriculture, food resources)
PROJECT DESCRIPTION
Summary of Accomplishments (Describe the project’s progress to date) Click here to enter text.
Describe any challenges faced and steps you took to overcome them: Click here to enter text.
What organizational capacity has been created by this project? Click here to enter text.
What steps have been taken to ensure project sustainability? Click here to enter text.
PROJECT MANAGEMENT & ORGANIZATIONAL CAPACITY
Describe your organizational capacity to manage this project and a VISTA: Click here to enter text.
Do you currently have the resources necessary to support a VISTA (cost share funds, office space, funds for mileage reimbursement, etc.)?Click here to enter text.
How would previous members (AmeriCorps and/or VISTA) describe the experience with your organization?Click here to enter text.
How much service related travel do you anticipate the VISTA will do during their service year?Click here to enter text.
What specific skills and qualifications will you look for in a VISTA member? Click here to enter text.
MEMBER SUPPORT
Who will supervise the VISTA and why? Click here to enter text.
Where will the VISTA be serving hours (office location)? What are the anticipated weekly service hours? Click here to enter text.
Are you able to provide housing and/or meal support? (Note: this is optional, but encouraged if possible)Click here to enter text.
On-site Orientation & Training (OSOT) – What is your training plan for the first two weeks? Please highlight the main activities that your VISTA will participate in: Click here to enter text.
What other benefits are you able to provide the VISTA (Ex: professional development, further trainings): Click here to enter text.
PERFORMANCE MEASURES
Please select all of the metrics on the following page that you will anticipate will apply to your project.
Performance Measure / Check (if applicable) / Target Number# of community volunteers VISTA members recruited
#, total service hours community volunteers recruited by VISTA member
$ value of cash resources leveraged by VISTA member
$ value of in-kind resources leveraged by VISTA member
#, hours VISTA member spent participating in community volunteer recruitment training
#, hours VISTA member spent participating in effective volunteer management training
# of economically disadvantaged individuals receiving housing placement services because of VISTA capacity building efforts
# of economically disadvantaged individuals transitioned into housing because of VISTA capacity building efforts
ADDITIONAL INFORMATION
Is your organization currently a member of HHCK? If yes, are you current on HHCK dues? Click here to enter text.
Note: Each agency awarded a Homes for All VISTA through HHCK must become a paying member of HHCK.
Initial the following –
____Disclosure: Completing the information contained herein is no way a guarantee that your organization will receive a VISTA member. HHCK will receive funding award and slot notification in March. The information provided here will assist HHCK in determining slot allocations.
____HHCK staff will notify each site of selection decision by the end of March.
____The completed VISTA Assignment Description has been sent to HHCK program staff, if changes have been made.
Signature: Click here to enter text.Date: Click here to enter text.