MCSC Service to Employment Pilot Member Recommendation Survey

Thank you for taking the time to complete this survey. All information provided will be kept confidential and only be used for the MCSC Service to Employment pilot project. Upon completion of this survey, you will receive a follow up email with further instructions.

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1. Please provide the following information about yourself:

Please provide the following information about yourself: Name
Title
Organization
Mailing Address
City/State/Zip
Telephone Number
Email Address

2. If the individual you are recommending has given his/her consent to do so, please provide the following information:

If the individual you are recommending has given his/her consent to do so, please provide the following information: Name of Recommended Individual
Mailing Address
City/State/Zip
Telephone Number
Email Address

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3. Please share with us why you think AmeriCorps would be a good fit for the recommended individual.

Please share with us why you think AmeriCorps would be a good fit for the recommended individual.

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4. Have you discussed AmeriCorps as an opportunity with the individual you are recommending?

Have you discussed AmeriCorps as an opportunity with the individual you are recommending? Yes

Comments (optional):

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5. Are you providing professional services to the individual you are recommending?

Are you providing professional services to the individual you are recommending? Yes

Comments (optional):

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6. Is the recommended individual a client/customer of Community Mental Health (CMH)?

Is the recommended individual a client/customer of Community Mental Health (CMH)? Yes

I don't know

7. Please select the known areas of interest for the individual you are recommending (check all that apply).

Please select the known areas of interest for the individual you are recommending (check all that apply). Education (Mentoring, Post-Secondary Opportunities, Youth Involvement)

Community Development (Low-Income Assistance, Creating Friendly Neighborhoods, Public Safety, Volunteer Engagement)

Economic Opportunity (Money Management, Employment/Job Readiness, Protecting Your Home from Foreclosure)

Environment (Urban Agriculture, Community Gardens, Environmental Education, Sustainable Energy, Thinking Green)

Vulnerable Populations/Individuals Needing Support (Prisoner Re-entry, Reintroduction to Community Life, Elderly Assistance, Programs Assisting Individuals with Disabilities)

Other (please specify)

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8. Does the recommended individual have employment, volunteer, or other relevant experience in any of the above service areas?

Does the recommended individual have employment, volunteer, or other relevant experience in any of the above service areas? Yes (please explain)

I don't know

Explanation of related experience:

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9. Where is the recommended individual interested in serving (check all that apply)?

Where is the recommended individual interested in serving (check all that apply)? Southeast Michigan

West Michigan

Southwest Michigan

Central Michigan

Northern Michigan (Lower Peninsula)

Northern Michigan (Upper Peninsula)

I don't know

Comments (optional):

10. Are there any geographical limitations? Please specify.

Are there any geographical limitations? Please specify.

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11. Most AmeriCorps programs require a one-year commitment with the number of required hours ranging from full-time (1700 hours in one year) to minimum-time (300 hours). Please indicate the level of commitment the recommended individual would be interested in doing (check all that apply).

Most AmeriCorps programs require a one-year commitment with the number of required hours ranging from full-time (1700 hours in one year) to minimum-time (300 hours). Please indicate the level of commitment the recommended individual would be interested in doing (check all that apply). Full-time (1700 hours)

Half-time (900 hours)

Quarter time (450 hours)

Minimum time (300 hours)

I don't know

Comments (optional):

12. Is there anything else you would like to share with us regarding the individual you are recommending?

Is there anything else you would like to share with us regarding the individual you are recommending?

Thank you for taking the time to complete this survey. If you have any questions about Michigan's AmeriCorps or the NextSTEP pilot project, please contact Kathleen Egan at egank@michigan.gov or (517) 335-6585.

MCSC Service to Employment Pilot Member Recommendation Survey
Exit this survey

1. Survey Questions

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1. Please provide the following information about yourself:

2. If the individual you are recommending has given his/her consent to do so, please provide the following information:

*
3. Please share with us why you think AmeriCorps would be a good fit for the recommended individual.

*
4. Have you discussed AmeriCorps as an opportunity with the individual you are recommending?

*
5. Are you providing professional services to the individual you are recommending?

*
6. Is the recommended individual a client/customer of Community Mental Health (CMH)?

7. Please select the known areas of interest for the individual you are recommending (check all that apply).

*
8. Does the recommended individual have employment, volunteer, or other relevant experience in any of the above service areas?

*
9. Where is the recommended individual interested in serving (check all that apply)?

10. Are there any geographical limitations? Please specify.

*
11. Most AmeriCorps programs require a one-year commitment with the number of required hours ranging from full-time (1700 hours in one year) to minimum-time (300 hours). Please indicate the level of commitment the recommended individual would be interested in doing (check all that apply).

12. Is there anything else you would like to share with us regarding the individual you are recommending?

MCSC Service to Employment Pilot Member Recommendation SurveyExit this survey

1. Survey Questions

*1. Please provide the following information about yourself:

2. If the individual you are recommending has given his/her consent to do so, please provide the following information:

*3. Please share with us why you think AmeriCorps would be a good fit for the recommended individual.

*4. Have you discussed AmeriCorps as an opportunity with the individual you are recommending?

*5. Are you providing professional services to the individual you are recommending?

*6. Is the recommended individual a client/customer of Community Mental Health (CMH)?

7. Please select the known areas of interest for the individual you are recommending (check all that apply).

*8. Does the recommended individual have employment, volunteer, or other relevant experience in any of the above service areas?

*9. Where is the recommended individual interested in serving (check all that apply)?

10. Are there any geographical limitations? Please specify.

*11. Most AmeriCorps programs require a one-year commitment with the number of required hours ranging from full-time (1700 hours in one year) to minimum-time (300 hours). Please indicate the level of commitment the recommended individual would be interested in doing (check all that apply).

12. Is there anything else you would like to share with us regarding the individual you are recommending?

MCSC Service to Employment Pilot Member Recommendation Survey
Exit this survey

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1. Please provide the following information about yourself:

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3. Please share with us why you think AmeriCorps would be a good fit for the recommended individual.

*
4. Have you discussed AmeriCorps as an opportunity with the individual you are recommending?

*
5. Are you providing professional services to the individual you are recommending?

*
6. Is the recommended individual a client/customer of Community Mental Health (CMH)?

*
8. Does the recommended individual have employment, volunteer, or other relevant experience in any of the above service areas?

*
9. Where is the recommended individual interested in serving (check all that apply)?

*
11. Most AmeriCorps programs require a one-year commitment with the number of required hours ranging from full-time (1700 hours in one year) to minimum-time (300 hours). Please indicate the level of commitment the recommended individual would be interested in doing (check all that apply).