Community Health Worker Public Health AmeriCorps Apprentice Application

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Silver Thread Public Health Mission Statement:
We are committed to eliminating barriers to health and wellness, building resilience, and empowering our community to live a healthy life, through education, support, and access.

Thank you for applying for the 2022-2023 Community Health Worker Apprenticeship at Silver Thread Public Health in Lake City, Colorado. If you are passionate about exploring a career in public health and love working with young people this could be the position for you!

This position is open until filled. We will respond to all applicants within one week of completed submissions. Follow up interviews will be arranged beginning the last week in August until the positions are filled.

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, sex, gender, age, national origin, marital status, disability, or any other legally protected status.

If you need any accommodation to participate in the application or interview process please contact our office via email or call us at 719-658-2416. For more information about our organization please visit us at www.silverthreadpublichealth.org

Email *

Name *

First and last name

Date of Birth *

YYYY

Email *

Phone number *

Earliest date available to begin work in person in Lake City Colorado? *

YYYY

How did you hear about this position? *

Are you a U.S. Citizen? (Unfortunately Citizenship is required for this position). *

Yes

What is the highest level of education you have completed? *

High School

Some College

College

Graduate School

What about the Community Health Worker apprenticeship most inspired you to apply? *

Lake City Colorado is a remote mountain community, requiring an hour's drive to the nearest small city. What excites you about living in a small community high up in the mountains? *

Do you have any experience living or working in rural or remote settings? If Yes, please describe. *

Please describe any experience you have working with youth. *

Our organization is working to create belonging for everyone as a central public health need. This requires deep personal and organizational work to address justice, diversity, equity, and inclusion. Please share any experience you have had working on justice, equity, diversity, and inclusion in your personal or professional work. *

Please describe your personal and professional goals through this apprenticeship. *

Please describe your level of proficiency in using Google Workspace (Gmail, Drive, Chat, Spaces) and other computer programs such as excel, powerpoint, etc. *

References

Please provide Name, email, and phone number for three professional and/or academic references. Please also list your relationship to each reference (i.e. Academic Advisor, Supervisor at x-job, etc.)

Reference 1 *

Reference 2 *

Reference 3 *

Employment or volunteer History

Please list your three most recent jobs or volunteer experiences starting with your present or last job. Please list your roles, dates of employment, and reason for leaving.

Job 1 *

Job 2 *

Job 3

Were you ever discharged, asked to resign, or subjected to disciplinary action while working at any previous job? If yes, please explain. *

Criminal History

We do not discriminate on the basis of criminal or incarceration history. However, for this position some convictions do bar people from working with youth.

Have you have ever been detained by a law enforcement officer, arrested, served time in jail or prison, or been convicted of a crime? If Yes, please explain. *

Applicant’s Statement:

The information that you provide on this application is subject to verification. Falsifications or misrepresentations may disqualify you from consideration for employment or, if hired, may be grounds for termination at a later date.

With my signature below (typed or written), I certify that all information on this and all attached pages is true, correct and complete to the best of my knowledge and contains no willful falsifications or misrepresentations. I authorize all former employers to release job-related information they may have about me and I release all persons or companies from any liability or responsibility for providing such information.

Signature of Applicant and Date

A copy of your responses will be emailed to the address you provided.

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