Colorado Public Health Works Program - Community Health Worker AmeriCorps Apprentice
We are excited you are interested in a position at a Local Public Health Agency in Colorado! Participants will be serving an AmeriCorps term AND simultaneously earning an Apprenticeship credential as a Community Health Worker with the US Department of Labor. 
Sign in to Google to save your progress. Learn more
Email *
Name (as shown on your government ID) *
Preferred pronouns
Street Address *
City, State, Zip Code *
Phone Contact *
Have you served with AmeriCorps previously? *
Required
Tell us about yourself and what interests you most about our program? *
Did you review the open host site applications or apply to any of the organizations on our website?  https://trailhead.institute/colorado-public-health-works-program  *
Required
Which organizations did you apply?
Acknowledgements
Please INITIAL the following statements to ensure eligibility for AmeriCorps service.
I am a US citizen, US national, or lawful permanent resident alien of the United States. (*NOTE: this is a requirement for AmeriCorps service) *
I am at least 17 years of age at the commencement of service.  *
I allow the Trailhead Institute Colorado Public Health Works Program to conduct a National Service Criminal History Check. The program will uphold confidentiality of the applicant on any findings.**Member participation is contingent upon criminal history review and all applicants have the right to challenge the results two weeks from the criminal history check but may not challenge the program's decision to disqualify the individual from participation. *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy