INSTRUCTIONS
Please complete the following application and submit to the Iowa Commission on Volunteer Service (ICVS or “Volunteer Iowa”) VISTA Project Coordinator:
Nicole Quade
200 E. Grand Ave. 1.800.308.5987
Des Moines, IA 50309
It is strongly suggested that potential applicants review the application and the “Facts for Host Site Applicants” document and contact the ICVS VISTA Project Coordinator with questions in advance of submitting this application, to ensure that the VISTA program is a good fit for the applicant agency.
PART ONE: GENERAL INFORMATION
Title for the AmeriCorps VISTA Position (must include the phrase, “AmeriCorps VISTA”):
Area to be served by the VISTA (list the specific city, county, or region):
Host site name:
Host site mailing address:
Host site organization type (choose one): 501c(3), state government agency, local government agency, K-12 school, institute of higher education, faith based organization, other (please indicate)
Host site EIN number:
Is your organization a certified Service Enterprise (For additional information about the Service Enterprise Initiative contact ): / Yes / No
Host site contact (will serve as contact with ICVS during application process): / Site supervisor (will serve as contact with ICVS if a position is awarded):
Phone: / Phone:
Email: / Email:
Population served by VISTA (elementary, middle, or high school): / Number of VISTA positions requested:
Host site is able to contribute $3,500 cost share funding per member (awarding priority will be given to organizations able to provide cost share funding):
If no, cost share amount you are able to provide:
PART TWO: COMMUNITY NEED AND PROJECT GOAL
Community need statement: (The suggested length of this statement is 3-6 sentences. Include the following information: Explain the community’s specific poverty-related need to be addressed. Describe the need in measurable terms. Include relevant characteristics of the community, including the number of low-income people directly affected by the identified problem or unmet need.Cite a reliable source that documents the need in the area being served. Briefly explain the VISTA sponsor’s capacity to address the need.)
Goal statement: The suggested length of this statement is 1-3 sentences. Include the following: Describe who (population) will be served by the VISTA, describe what the VISTA will do using verbs (develop, implement), describe how poverty is addressed by VISTA efforts (breaking the cycle of poverty by…), state the specific self-sustaining product or service resulting from the VISTA efforts (volunteer systems, partnerships, funding), and if applicable describe how resources will be used (VISTA will write grants to support…).
Sustainability: (The suggested length of this statement is 1-3 sentences. Describe in measurable terms the anticipated sustainability of results at the conclusion of the project.)
Planning: (The suggested length of this statement is 1-3 sentences. Indicate the involvement of beneficiaries (as an advisory group) in project development and implementation throughout the life of the project.)
Volunteer Management: (The suggested length of this statement is 1-3 sentences. Indicate the role of the VISTA member in developing or enhancing the ability of the organization or partner organization(s) to implement effective volunteer management best practices and/or engage volunteers in meaningful service.)
PART THREE: VISTA ASSIGNMENT DESCRIPTION (VAD)
Assignment description: The VISTA assignment description should identify key capacity building tasks and activities that can be realistically accomplished in a single year.
Please develop 2-4 objectives for the VISTA member, identify the steps to complete the objective, and the planned period of service (e.g. Months 1-6, Months 4-12, etc.). Include enough detail in the activity description to guide the VISTA member while still allowing for flexibility in carrying out day-to-day tasks and activities. Please review the resources listed in “Facts for Host Site Applicants” for additional assistance.
Note to current sites: the goal of VISTA is sustainability, so your VAD should change and build off the accomplishments of current members.
SAMPLE
Objective: Establish volunteer management infrastructure to assist with service delivery
Step 1: Develop the policies and procedures for the recruitment, screening, training, and supervision of volunteers.
Step 2: Develop volunteer recruitment, screening, training, and supervision materials.
Step 3: Train all staff members in volunteer policies and procedures.
Step 4: In collaboration with staff, conduct an organizational needs assessment to identify potential positions for volunteers and create volunteer position descriptions. / Planned Period of Service
Months 1-5
Objective:
Step 1:
Step 2:
Step 3 (if needed):
Step 4 (if needed):
Step 5 (if needed): / Planned Period of Service
Objective:
Step 1:
Step 2:
Step 3 (if needed):
Step 4 (if needed):
Step 5 (if needed): / Planned Period of Service
Objective (if needed):
Step 1:
Step 2:
Step 3 (if needed):
Step 4 (if needed):
Step 5 (if needed): / Planned Period of Service
Objective (if needed):
Step 1:
Step 2:
Step 3 (if needed):
Step 4 (if needed):
Step 5 (if needed): / Planned Period of Service
Comments:
PART FOUR: PERFORMANCE MEASURES
All Volunteer Iowa AmeriCorps VISTA sites are required to report to the ICVS on a quarterly basis. Quarterly reports include a progress report, tracking general measures for all VISTAs, and measures specific to the individual’s focus area. The measures provided below do NOT constitute an exhaustive list of all the measures that must be tracked on a quarterly basis, but they are included to give an idea of the tracking systems that host sites will need to develop. Other reports may be added, as needed.
Capacity building activities: All Volunteer Iowa AmeriCorps VISTA members will provide capacity building services to at least one organization (their host site). We hope your members will help other agencies in the community. Please list numerical targets for the VISTA member in the following categories of capacity building activities.
Capacity Building Activity / Target
  1. Number of community volunteers managed by the VISTA-supported organization or by the VISTA member.
(Please do not count volunteers managed by other National Service Program Members, including VISTA, AmeriCorps State and National, Senior Corps, Volunteer Generation Fund, etc.).
  1. Number of organizations implementing three or more effective volunteer management practices as a result of capacity building services provided by the VISTA member or host site as measured by a pre/post organizational assessment tool.
(You must at least include your organization in this count.)
  1. Number of organizations that will receive capacity building services as a result of capacity building services provided by the VISTA member.

Focus area activities: All Volunteer Iowa AmeriCorps VISTA members serving under the Education Focus area will be asked to track performance measures. Please indicate the numerical targets for the education performance measures listed below.
Education Performance Measures
Choose one of the following: / Target
  1. Number of students that completed participation in VISTA-supported K-12 education programs, not including mentoring programs.
(At the outset of the VISTA service, the site should indicate how much time (i.e. how many days or hours) is required to complete the program. Then they will only count the number of students who meet that threshold by the end of the program or activity.)
  1. Number of disadvantaged youth/mentor matches or children with special or exceptional needs/mentor matches that were sustained by the VISTA-supported program for at least the required time period.
(Forschool-based mentorships, count mentees in those matches that are intended to be continuous, with the same mentor for one hour per week (or as age-appropriate for older mentees), for at least 6 months of one school year. Forcommunity-based mentorships, count mentees in those matches that are intended to be continuous, with the same mentor, for at least 12 months.Mentoring relationshipsare ideally one mentor per child, but could be small group with a ratio of no more than 1:3.)
  1. Number of students in grades K-12 that participated in the mentoring or tutoring or other education program, including VISTA-supported service learning, who demonstrated improved academic engagement.
(Improved academic engagement is a positive and significant change in one of the following student behaviors or attitudes over the course of a school year. Measures of student behaviors include: increased attendance, increased completion of assignments including homework, increased teacher-reported participation, decreased disciplinary referrals and decreased reports of substance abuse. Measures of student attitudes include: increased interest in school, improved perspective on school climate, increased attachment to school and increased educational aspirations.)
PART FIVE: CONNECTION TO ICVS & NATIONAL SERVICE
Connection to the Iowa Commission on Volunteer Service mission, vision, and objectives: (Reference the 2013-2016 Iowa State Service Plan, developed by the ICVS and our partners. Describe in two to four sentences how the proposed AmeriCorps VISTA project relates to the ICVS mission, vision, and goals for service in Iowa.)
Does your service site have any other relationships to the ICVS? If yes, please describe: (Examples may include: staff member serves on the Commission, staff serve on planning committee for Iowa Nonprofit Summit, agency hosts another program or grant awarded through the ICVS, etc.)
Other AmeriCorps programming at your site: (Are there other AmeriCorps members serving at your site? If yes, please share what you know about their service, such as what branch of AmeriCorps and what program. How will the AmeriCorps VISTA’s duties relate to the existing members’ service activities?)
Other national service programming at your site: (Are there other national service programs at your site (i.e. Senior Corps, Foster Grandparents, Senior Companions, Volunteer Generation Fund)? If so, how will the AmeriCorps VISTA activities complement the other national service programming?)
Service experience and training: (The suggested length of this statement is 1-3 sentences. Please address how your organization will ensure a meaningful service experience for the AmeriCorps VISTA member. What training opportunities will you offer the member?)
Monitoring: (The suggested length of this statement is 3-4 sentences. Please address how your AmeriCorps VISTA member will be supervised on-site, how you will monitor the VISTA member’s progress toward the targets identified in the VAD, and your ability to complete and submit reports in a timely fashion.)

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