1.

* 1. Please fill in the requested information about the AmeriCorps National program.

* 2. Please provide Indiana contact information, if available.

* 3. Application type:

* 4. Grant type:

* 5. Program Model:

* 6. Budget Information

* 7. Total # of slots in Indiana:

* 8. Brief description of primary AmeriCorps program activities:

* 9. Please describe your program.

* 10. Overview of proposed site(s):

Please include information on service site organization, location of site, and number of members at each site.

* 11. What are two of the primary ways you think State Commissions can collaborate with AC National programs?

T