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COVID-19 in Montana may create situations in which statewide, regional, and local leaders face increased significant community challenges and organization needs that AmeriCorps programs and members may be able to alleviate. To be considered for one or more AmeriCorps members to serve to alleviate such needs, complete this form.

 Completed requests will be reviewed for safety and allowability under AmeriCorps rules, CDC Guidelines, and Governor declarations regarding COVID19. Approvals will be made based on member safety, allowability, and other factors determined by the Governor’s Office. Even if approved, the Governor’s Office reserves the right to suspend activities for any reason.

Members and staff may not engage in AmeriCorps Prohibited Activities. https://www.nationalservice.gov/sites/default/files/documents/acprohibited_activities.pdf   

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* 1. Requestor contact

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* 2. What is the community need as a result of COVID-19?

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* 3. What is the requested service activity?

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* 4. Where will be the requested service activity be performed?

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* 5. How many service members are you requesting?

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* 6. Who will the service activity benefit?

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* 7. When will proposed activities begin and end (dates)?

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* 8. How many hours weekly do you estimate as needed for the activity?

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* 9. How will members be trained and supervised?

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* 10. How will member safety be assured?

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* 11. Signature:

Thank you for your request! 
For confirmation, please send an email to serve@mt.gov 

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