S4S State Service Leader (SSL) Sign-Up Form

Candidate Questionnaire / Application Form

If you are interested in being considered as one of our founding States for Service (S4S) State Service Leaders (SSLs), please complete the following form. To learn more about SSL responsibilities and eligibility criteria, click here to view our flyer.

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* 1. Candidate Name:

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* 2. Affiliation:

State Service Commission

AmeriCorps State or Other State Service Program

Please specify the name of the commission/program you are affiliated with below:

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* 3. Candidate Contact Information:

Title/Position

Organization

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 4. Candidate Reference (should be someone involved in state service):

First and Last Name

Organization

Email Address

Phone Number

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* 5. Why are you interested in serving as a State Service Leader (SSL)?

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* 6. What unique skills or abilities would you bring to the States for Service (S4S) Coalition, including relevant experience in public policy, group organizing, communications, and event coordination?

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* 7. Certification - By submitting my candidacy for the Coalition Leadership Council, I understand that I am aware of the following requirements and responsibilities:

Eligibility Requirements:

Be a current member of States for Service Coalition (must pay annual dues of $50/individual, $250 programs/partners, or $500/state service commissions)

Use non-federally funded time for coalition activities (may be privately funded or volunteer time)

Commission Leaders: Must be a Commissioner, commission staff, or alumni

Program Leaders: Must be a staff member, Board member, or AmeriCorps Alumni of an AmeriCorps State or other state service program

Leader Responsibilities and Activities:

Commit to a 2-year term, with the option to renew

Represent the needs and interests of your state

Attend States for Service Coalition training (can be done virtually)

Attend monthly S4S calls

Help set strategy and develop key campaigns to promote state service

Engage peers and communicate across your region/cluster for specific campaigns

Organize meetings with elected officials and mobilize networks such as Commissioners, program board members, etc. (ex. August Recess office visits, Hill Visits, thank you note and letter-writing campaigns)

Track, collect, and report on state-specific engagement data (calls, meetings, etc.)

Help recruit future SSLs and S4S members

I understand and am aware of the above requirements and responsibilities, and give permission to S4S to contact my reference.

Please submit this form no later than November 3, 2017.

Questions? Contact Tom Branen at tbranen@statecommissions.org or (202) 207-5389.