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Thank you for your service with AmeriCorps National Civilian Community Corps (NCCC).

Below are a series of questions regarding your interactions and experiences while serving in the program. It should take approximately 15 minutes to complete.


PUBLIC BURDEN STATEMENT: Public reporting burden for this collection is estimated to average 15 minutes per submission, including reviewing instructions, gathering and maintaining the data needed, completing the form, and reviewing the collection of information. Comments on the burden or content of this instrument may be sent to the Corporation for National and Community Service, Attn: Amy Borgstrom, 250 E. Street SW, Washington, D.C. 20525. You are not required to respond to the collection unless the OMB control number and expiration date displayed on page 1 are current and valid. (See 5 C.F.R. 1320.5(b)(2)(i).)

Privacy Notice: respondents are informed that their responses to this survey will be used and may be disclosed by CNCS in accordance with Federal Law.

OMB Control Number: 3045-0181
Expiration Date: 01/31/2023


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