Indiana AmeriCorps National Consultation 1. Question Title * 1. Please fill in the requested information about the AmeriCorps National program. Organization: AmeriCorps Program Name: Contact Name: Address: City/Town: State: -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP: Email Address: Phone Number: Question Title * 2. Please provide Indiana contact information, if available. Name: Organization: Address: City/Town: State: -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP: Email Address: Phone Number: Question Title * 3. Application type: New Recompete Continuation Year 1 Continuation Year 2 Planning Grant Indiana Tribe Question Title * 4. Grant type: Cost-Reimbursement Full time Fixed Amount Education Award Program Professional Corps Question Title * 5. Program Model: National (members at local organizations directly controlled by parent) Affiliates (members at affiliates of parent – limited direct control) Consortium (members at independent organizations that interact on activities beyond AmeriCorps) Intermediary (members at unrelated organizations) Question Title * 6. Budget Information Total Program Operating Budget: Total CNCS Budget Request: Cost per MSY: Question Title * 7. Total # of slots in Indiana: Full time Half Time Reduced Half Time Quarter Time Minimum Time Question Title * 8. Brief description of primary AmeriCorps program activities: Question Title * 9. Please describe your program. Proposed outcomes, including targets: Results of previous years performance measures: Prior year enrollment rate in Indiana: Prior year retention rate in Indiana: Overall enrollment rate: Overall retention rate: Number of program staff in Indiana: Question Title * 10. Overview of proposed site(s):Please include information on service site organization, location of site, and number of members at each site. Question Title * 11. What are two of the primary ways you think State Commissions can collaborate with AC National programs? Done