NYC Civic Corps Host Site Application

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NYC Civic Corps 2012-2013 Host Site Application Request for Applications Through this Request for Applications (RFA), NYC Service is seeking applications from nonprofit organizations and City agencies for the 2012-2013 program year of the NYC Civic Corps. About NYC Service: Launched in April 2009 by Mayor Michael R. Bloomberg, NYC Service is leading the nation in answering President Obama's call to service. NYC Service aims to achieve three goals: helping more New Yorkers connect to service opportunities more easily, targeting volunteers to address the city s greatest challenges, and promoting service as a core part of what it means to be a citizen of the greatest city in the world. To learn more visit nyc.gov/service or call 311. About NYC Civic Corps: The NYC Civic Corps is an AmeriCorps program run by NYC Service, a division of the Mayor's Office of the City of New York. The program unites a diverse group of professionals to serve full-time with partnering organizations, working to increase their organizational capacity to engage volunteers and build sustainable volunteer initiatives. NYC Civic Corps members have attained a minimum of a bachelor s degree and encompass a diversity of skills and backgrounds. Past corps members have ranged in age from 22 to 65, representing an assortment of work experience and achievement, with advanced degrees in business, law, social work, architecture, and more. NYC Civic Corps matches corps members to host organizations based on the need of the organization as described in the application and the interests and skills of the Civic Corps member. The 2012-2013 program year will run from October 1, 2012 - August 9, 2013. Applicant Organization Requirements and Responsibilities: To apply, organizations must meet the following criteria: Be a nonprofit organization registered as a 501(c)(3), public education institution or government agency. Comply with the requirements under New York State law to register and file annually with the office of the Attorney General, Charities Bureau, unless the organization can establish a valid basis for exemption. Serve residents within New York City. Administer programs that benefit the community as a whole. This criterion is particularly applicable to organizations with private, religious, or fraternal affiliations. Comply with the provisions of all Local, State and Federal laws governing employment and disabilities discrimination. Be willing and able to be reimbursed for NYC Civic Corps stipend provisions to a minimum of 2 active Civic Corps members per the procedure outlined on the Member Benefits Administration page of this application (see next page). Note: you will be asked to certify that your organization meets the criteria listed above when you complete the application.

If awarded an NYC Civic Corps team, organizations must: Designate an NYC Civic Corps supervisor within your organization to direct and coordinate the corps members' project(s) and act as liaison to NYC Service. Supervisors must be available to attend trainings as scheduled. Provide onsite orientation and training to familiarize NYC Civic Corps members with mission, structure and operations of the organization. Provide NYC Civic Corps team with an adequate work space in a safe environment, including consistent and continuous access to computer, internet, and phone. Comply with requirements for tracking metrics and regular reporting on organization s and NYC Civic Corps program towards goals and outcomes. Comply with all AmeriCorps rules and regulations. This includes ensuring that corps members do not engage in Prohibited Activities as outlined by the Corporation for National and Community Service. Submit a signed Memorandum of Understanding. Application Release Date: April 10, 2012 Application Close Date: May 11, 2012 Please note that this project is contingent on receiving federal funding administered by the Corporation for National and Community Service and the New York State Commission for National and Community Service.

Administration of Member Benefits NYC Service will require that all selected partner organizations manage the provision of member stipends to their awarded and active corps members. NYC Service will reimburse host sites for the amount of the gross stipend ($1270) plus a supplemental $50 to cover the administrative cost of processing corps members on your organizations payroll, for a total of $1320 each month per corps member. Under this administrative model, NYC Service will: Reimburse host sites at prescribed intervals, scheduled four times during the service term. Reimburse host sites $50/corps member/month for payroll administration costs incurred. Note that although this Payroll Administration Support is incurred monthly, it will be reimbursed at each of the four reimbursement intervals (and not on a monthly basis). Manage the cost and provision of basic medical coverage to all active corps members. Under this administrative model, host sites must: Not exceed maximum gross stipend payment of $13,068.71 per corps member, or $1,270 per corps member per month based on a service term of 10.29 months. Please note this is the maximum amount that NYC Service will reimburse for any individual corps member, without adding administrative cost supplement. Distribute a fixed stipend to corps members on either a weekly, bi-weekly, semi-monthly, or monthly basis. Not distribute member stipends to inactive corps members, defined as: abandoning program, resigning, being exited for cause, or being suspended for any reason. Add corps members to payroll, process a W-4 for each member, and issue a W-2 (not Form 1099) for each member. Adhere to AmeriCorps regulations as they relate to the provision of member stipends (i.e. not contributing toward unemployment or providing fringe benefits, but subject to all other taxes). Things to know: NYC Civic Corps members length of service spans 45 weeks (or 10.29 months) from October 1, 2012 to August 9, 2013. The total gross stipend for each Civic Corps member is $13,068.71 for the entire service term (or $290.42 each week). NYC Civic Corps contributes up to $50 for each member during each month (decreased to $25 if a member becomes inactive before the 15 th of a particular month). Monthly Breakdown, per Civic Corps Member: Monthly Member Gross Stipend Monthly Payroll/Administrative Cost Contribution Monthly Reimbursable Cost to Host Site $1,270/member $50/member $1,320/member

Reimbursement Period Breakdown, based on placement of 2 Civic Corps members: Reimbursement of Member Stipend (Gross) Payroll / Administrative Cost Contribution Total Reimbursed Per Period $7,620 $300 $7,920 Note that corps members are placed in teams of at least two.

Application Instructions Only online application submissions will be accepted. Note that at the top of every page of this application is a Save & Continue link. Clicking this link at any page in the application will prompt you to provide an email address, and a unique link will be emailed to you that will allow you to return to your application where you left off. After submitting an email address to enable the Save & Continue feature, be sure to use the link sent most recently. Referring to the original email (and thus the original link) will simply take you back to the start of the application. Visit nyc.gov/service for more information about the NYC Civic Corps. Questions should be directed to corps@cityhall.nyc.gov or (212) 788-3209. Required Reading: Applicants should review the AmeriCorps Prohibited Activities to ensure that corps members will not be asked to perform - nor recruit or train volunteers to perform - any such activities. Applicants should review the AmeriCorps Performance Measures to complete the section entitled Metrics and AmeriCorps Performance Measures. Applicants are asked to identify metrics that the corps members will work to impact during their service term. This data will be measured monthly for each host site, and reported to the Corporation for National and Community Service at regular intervals. Applicants should review the Member Position Description Instructions and complete the Member Position Description Template in preparation for submitting position description(s) with this application. Likewise, applicants should review the Project Plan Guidelines and reference the Project Plan Template in preparation for submitting proposed project plan(s) with this application. Required Attachments: Member Position Description(s) Project Plan(s) Organizational Chart You will be prompted to upload these files on later pages of this application.

Certification of Applicant Requirements Please certify that your organization meets all requirements of the NYC Civic Corps before completing the application.* I certify that the applicant organization/entity: [ ] is a nonprofit organization registered as a 501(c)(3), public education institution or government agency. [ ] complies with the requirements under New York State law to register and file annually with the office of the Attorney General, Charities Bureau, unless the organization can establish a valid basis for exemption. [ ] serves residents within New York City [ ] administers programs that benefit the community as a whole. This criterion is particularly applicable to organizations with private, religious, or fraternal affiliations. [ ] complies with the provisions of all local, state and federal laws governing employment and disabilities discrimination [ ] is willing and able to be reimbursed for NYC Civic Corps stipend provisions to a minimum of 2 active Civic Corps members as per the Member Benefits Administration outlined on the previous page of this application.

Organization Information 1) Organization Contact Information* Legal name of organization*: Alternative name(s) of organization: Street Address 1*: Street Address 2: City*: Zip Code*: Organization Web Address*: 2) Borough* ( ) Brooklyn ( ) Bronx ( ) Manhattan ( ) Queens ( ) Staten Island 3) Organization Size* Number of full-time staff: Number of part-time staff: 4) Organization Type* ( ) Nonprofit organization (501c3) ( ) City agency 5) 501(c)(3) EIN/TIN Number (no dashes): (only visible if applicable)

6) Executive Director Contact Information* This information will only be used to communicate application decisions. All interim communication regarding the application process, including confirmation of application receipt and any follow-up questions regarding application content, will be coordinated with the staff person completing this application (contact information to be entered below). First Name: Last Name: Phone (XXX-XXX-XXXX): Email: 7) Staff Information* NYC Service requires that one staff member serve as the NYC Civic Corps Host Site Supervisor the main liaison between our office and your organization. The supervisor manages, or coordinates the management of, assigned corps members and is responsible for completing and submitting monthly metric reports. [ ] Staff member completing this application has been designated to serve as Civic Corps Supervisor. [ ] Staff member completing this application is not the staff person designated to serve as Civic Corps Supervisor. [ ] A staff member has not yet been designated to serve as Civic Corps Supervisor. (In this case, NYC Service will communicate application information with the application preparer.) 8) Staff Member to serve as Civic Corps Supervisor* (only visible if applicable) First Name: Last Name: Title: Phone (XXX-XXX-XXXX): Email: 9) Staff Member completing this application* (only visible if applicable) First Name: Last Name: Title: Phone (XXX-XXX-XXXX): Email: 10) Staff Member to serve as Fiscal Representative* (only visible if applicable)

The staff person listed here will be the primary point of contact for coordinating reimbursement of member stipends. First Name: Last Name: Title: Phone (XXX-XXX-XXXX): Email:

Organization Background 11) What is your organization's mission?* (300 word limit) 12) What borough(s), neighborhood(s), and/or specific population(s) does your organization serve?* (300 word limit) 13) Does your organization currently engage volunteers? If so, how? Please specify which projects use volunteers and in what way.* (300 word limit) 14) Please select all that apply to describe your relationship with NYC Service: [ ] NYC Service website user (organization is registered and posts volunteer opportunities) [ ] Partner for one-time events (past or future) [ ] NYC Service Initiative partner [ ] 2009-2010 NYC Civic Corps Host Site [ ] 2009-2010 NYC Civic Corps Host Site Applicant [ ] 2010-2011 NYC Civic Corps Host Site [ ] 2010-2011 NYC Civic Corps Host Site Applicant [ ] 2011-2012 NYC Civic Corps Host Site [ ] 2011-2012 NYC Civic Corps Host Site Applicant [ ] Other 15) Please describe:

Project Overview 16) If an NYC Civic Corps team is awarded to your organization, what volunteer projects will corps members build or support?* Be sure to connect their impact to the Performance Measures you will indicate in the next section of this application. Please be as specific as possible within the word limit, noting that the project plan you submit with this application is expected to describe these projects in greater depth. (300 word limit) 17) Will the NYC Civic Corps members be working on existing volunteer-using programs?* Answering NO indicates that corps members will be developing new programs. ( ) Yes ( ) No 18) Please list the names of the program(s) on which corps members will focus. (only visible if applicable) 19) Which of the following best describes how your organization would use the NYC Civic Corps team as a resource?* [ ] INFRASTRUCTURE BUILDING: The primary work of the corps members will be to build or improve the systems and protocols with which the host organization engages volunteers, with the goal of making the work of volunteers more efficient and impactful. Projects may include building a database, creating a volunteer application and training process, or developing recruitment materials. Infrastructure building is often necessary at organizations that do not yet have a formal volunteer program. [ ] FORCE MULTIPLICATION: The primary work of the corps members will be to significantly increase number of volunteers recruited and utilized by the organization. Projects may include managing volunteer communications, developing and implementing a volunteer recruitment strategy, or creating a plan to improve volunteer retention. Force multiplication is often necessary at organizations that already have established volunteer programming. [ ] BOTH infrastructure building and force multiplication. [ ] NEITHER. Please use the space below to describe the nature of your proposal. 20) Please describe your answer. (100 word limit)

21) Will the NYC Civic Corps members be working on ALL of the programs within your organization that utilize volunteers?* ( ) Yes ( ) No 22) Please list any of your organization's programs that utilize volunteers which your corps members will NOT focus on.

Organization Structure 39) Which department(s) within your organization will corps members work within? (Up to 100 words)* 40) Does your organization have experience with federal national service programs (Senior Corps, AmeriCorps, VISTA, etc.)?* ( ) Yes ( ) No 41) Please list relevant programs and dates of participation. 42) NYC Civic Corps members are placed at host organizations in teams of 2 to 8 members. How many corps members would you like to request? * Note that the amounts listed below are approximations based on a stipend amount of $1270/month/corps member. Format: [Size of Civic Corps team] @ [Monthly Cost]. [Estimated Cost Incurred by Host Site prior to Reimbursement from NYC Service]. [ ] 2 corps members @ $2,540/month. Approximately $7,620 to be reiumbursed every 3 months. [ ] 3 corps members @ $3,810/month. Approximately $11,430 to be reimbursed every 3 months. [ ] 4 corps members @ $5,080/month. Approximately $15,240 to be reimbursed every 3 months. [ ] 5 corps members @ $6,350/month. Approximately $19,050 to be reimbursed every 3 months. [ ] 6 corps members @ $7,620/month. Approximately $22,860 to be reimbursed every 3 months. [ ] 7 corps members @ $8,890/month. Approximately $26,670 to be reimbursed every 3 months. [ ] 8 corps members @ $10,160/month. Approximately $30,480 to be reimbursed every 3 months. 43) In which borough(s) would your NYC Civic Corps team report to work for the majority of their assignment?* (Select all that apply) [ ] Bronx [ ] Brooklyn [ ] Manhattan [ ] Queens [ ] Staten Island

44) Language proficiencies preferred (in addition to English): Spoken Written Spanish [ ] [ ] Chinese (Cantonese) [ ] [ ] Chinese (Mandarin) [ ] [ ] Korean [ ] [ ] Russian [ ] [ ] French [ ] [ ] Haitian Creole [ ] [ ] Japanese [ ] [ ] Arabic [ ] [ ] Other [ ] [ ] 45) If you selected Other on the question above, please specify the language: 46) Please identify the skills necessary for each position description from the below list.* (Select all that apply). [ ] Business/Entrepreneur [ ] Communications [ ] Community Org./Development [ ] Computers/Technology [ ] Conflict Resolution [ ] Counseling [ ] Education [ ] Fine Arts/Crafts [ ] First Aid [ ] Fundraising/Grant Writing [ ] Law [ ] Leadership [ ] Outreach [ ] Pubilc Health

[ ] Public Speaking [ ] Recruitment [ ] Teaching/Tutoring [ ] Trade/Construction [ ] Writing/Editing [ ] Youth Development [ ] Other 47) Please specify additional preferred skills:

Metrics and AmeriCorps Performance Measures The questions in this section help us to better understand the scope of your proposed project. Note that reporting low baseline volunteer engagement numbers will not harm your application. Selected host sites will range from organizations with well-established volunteer programs to organizations developing a volunteer program from scratch. It is more important that the proposed project plan aligns with the organization's needs as reflected by the baseline volunteer engagement numbers and organization's mission. 23) What systems or tools does your organization have in place to track progress and performance as it relates to volunteers impact?* Please outline specific metrics currently tracked and the method of collecting such data. (100 word limit) 24) In the past year (calendar or fiscal), approximately how many volunteers did your organization engage?* 25) How many volunteers do you expect to engage during the corps members' 10-month term of service?* 26) Which of the following NYC Service impact areas will your organization impact with the help of NYC Civic Corps members? Please check all that apply.* [ ] Strengthening Communities: Keeping our streets safe, our parks green, and our arts and cultural institutions strong [ ] Helping Neighbors in Need: Assisting those affected by the economic downturn and requesting social services [ ] Education: Helping youth in public schools [ ] Environment: Reducing energy utilization and shrinking the city's carbon footprint [ ] Health: Confronting major health challenges [ ] Emergency Preparedness: Preparing for and responding to emergencies 27) As outlined in the application instructions, applicants should refer to the AmeriCorps Performance Measures to answer the following question.

Which of the following performance measures will your organization impact with the help of corps members?* All applicants are pre-selected into Capacity Building, and should select all additional Performance Measures according to the work of their organization, the specific projects to be assigned to corps members, and their ability to report on the metrics outlined below. By selecting a Performance Measure, the applicant agrees to report on both OUTPUT and OUTCOME metrics listed. Though your organization may not have a tool in place to measure outcome metrics, implementing such a tool can be a component of the corps members' project. For each Performance Measure you select, you will be asked to briefly outline: a) how your members will impact this performance measure, and b) how you will track their progress along that measure (the metrics are pre-determined and can be referenced in the AmeriCorps Performance Meaures linked attachment above). [ ] Capacity building: Number of volunteers engaged (OUTPUT only). [ ] Opportunity: Financial Literacy. Number of economically disadvantaged individuals receiving financial literacy services (OUTPUT), and number of individuals demonstrating improved financial knowledge (OUTCOME). [ ] Opportunity: Reducing Hunger. Number of individuals receiving services to alleviate hunger (OUTPUT), and number of individuals reporting improved access to food services or reduced hunger (OUTCOME). [ ] Environment. Number of youth receiving education in energy-efficiency (OUTPUT), and number of those individuals reporting that they have changed their behavior towards a more energy-efficient/green lifestyle (OUTCOME). [ ] Healthy Futures: Health Education. Number of clients participating in health education programs (OUTPUT), and number of those individuals demonstrating improved health knowledge (OUTCOME). [ ] Healthy Futures: Reducing Childhood Obesity. Number of youth engaged in activities to reduce childhood obesity (OUTPUT), and number of those youth reporting improved attitude toward exercise and an active lifestyle (OUTCOME). [ ] Education: Tutoring and Academic Support. Number of students who start in an education program (OUTPUT 1), number of students who complete participation in an education program (OUTPUT 2), and number of students demonstrating improved academic performance (OUTCOME). [ ] Education: Mentoring. Number of youth/mentor matches started (OUTPUT 1), number of youth/mentor matches sustained for the required program duration (OUTPUT 2), and number of students demonstrating improved academic performance (OUTCOME). 28) Capacity Building OUTPUT: Number of volunteers engaged a) How will your members impact this performance measure? b) How will you track their progress along that measure? 29) Opportunity: Financial Literacy (only visible if applicable) OUTPUT: Number of economically disadvantaged individuals receiving financial literacy services

OUTCOME: Number of individuals demonstrating improved financial knowledge a) How will your members impact this performance measure? b) How will you track their progress along that measure? 30) Opportunity: Reducing Hunger (only visible if applicable) OUTPUT: Number of individuals receiving servicess to alleviate hunger. OUTCOME: Number of individuals reporting improved access to food services or reduced hunger a) How will your members impact this performance measure? b) How will you track their progress along that measure? 31) Environment (only visible if applicable) OUTPUT: Number of youth receiving education in energy-efficiency OUTCOME: Number of those individuals reporting that they have changed their behavior towards a more energyefficient/green lifestyle a) How will your members impact this performance measure? b) How will you track their progress along that measure? 32) Healthy Futures: Health Education (only visible if applicable) OUTPUT: Number of clients participating in health education programs OUTCOME: Number of those individuals demonstrating improved health knowledge a) How will your members impact this performance measure? b) How will you track their progress along that measure? 33) Healthy Futures: Reducing Obesity (only visible if applicable) OUTPUT: Number of youth engaged in activities to reduce childhood obesity OUTCOME: Number of those youth reporting improved attitude toward exercise and an active lifestyle a) How will your members impact this performance measure? b) How will you track their progress along that measure? 34) Education: Tutoring and Academic Support (only visible if applicable) OUTPUT 1: Number of students who start in an education program OUTPUT 2: Number of students who complete participation in an education program OUTCOME: Number of students demonstrating improved academic performance

a) How will your members impact this performance measure? b) How will you track their progress along that measure? 35) Education: Mentoring (only visible if applicable) OUTPUT 1: Number of youth/mentor matches started OUTPUT 2: Number of youth/mentor matches sustained for the required program duration OUTCOME: Number of students demonstrating improved academic performance a) How will your members impact this performance measure? b) How will you track their progress along that measure?

Proposed Project Plan 46) As stated in the application instructions, applicants should review the Project Plan Guidelines and reference the Project Plan Template in order to prepare proposed project plan(s) with this application. Please upload the NYC Civic Corps Project Plan: Adobe PDF format is preferred, though Microsoft Word documents will also be accepted. Be sure to click UPLOAD after choosing your file to complete the upload. Files must be uploaded one at a time. To upload multiple files, simply click Choose File again after the previous file has completed uploading, and select the next file.

Proposed Member Position Description 47) As stated in the application instructions, applicants should review the Member Position Description Guidelines and reference the Member Position Description Template in order to prepare proposed position description(s) with this application. Please upload the NYC Civic Corps Member Position Description below. Adobe PDF format is preferred, though Microsoft Word documents will also be accepted. Be sure to click UPLOAD after choosing your file to complete the upload. Files must be uploaded one at a time. To upload multiple files, simply click Choose File again after the previous file has completed uploading, and select the next file.

Application Preparer Certification 48) Please certify that the information and commitments contained in this application have been reviewed by your organization's Executive Director and all staff that will be supervising corps members. Please certify that all information is accurate to the best of your knowledge by placing your initials in the box next to this statement:*

Thank You! Thank you for submitting an application for the 2011-2012 program year of the NYC Civic Corps. We look forward to reviewing your submission.