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Who We Are
- About Us
- Mission & History
- Staff & Board
- Office Locations
  - Bend
  - Sisters
  - Madras
  - Prineville
- Youth Stories
  - Chyanne
  - Sarah
  - Felipe
  - Gabe
  - Jasmine
  - Christian
  - Cameron
- Careers
- Contact Us
- Our Supporters
Apply for a Program
- Apply
- AmeriCorps
- COYCC
- Stewardship
- Thrift Store
- YouthBuild
- Camp LEAD
Get Involved
News & Events

Who We Are
- About Us
- Mission & History
- Staff & Board
- Office Locations
  - Bend
  - Sisters
  - Madras
  - Prineville
- Youth Stories
  - Chyanne
  - Sarah
  - Felipe
  - Gabe
  - Jasmine
  - Christian
  - Cameron
- Careers
- Contact Us
- Our Supporters
Apply for a Program
- Apply
- AmeriCorps
- COYCC
- Stewardship
- Thrift Store
- YouthBuild
- Camp LEAD
Get Involved
News & Events

Donate

Apply for a Program

YB youth_yes YOU

Apply
AmeriCorps
COYCC
Stewardship
Thrift Store
YouthBuild
Camp LEAD

We screen applicants based on their eligibility for our programs and their motivation to complete our programs. Please find more information about our programs by clicking here or using the links on the left.

This application is the first step for ALL programs. Some programs have multiple steps for enrollment.

Questions? Call us at (541) 633-7834.

Click here to download a PDF of the application.

Heart of Oregon Corps: Initial Application for ALL Programs

Which Heart of Oregon Corps Program(s) are you applying to? *REQUIRED

AmeriCorps
COYCC
Stewardship
YouthBuild
Not Sure (a staff member will call to discuss which program fits your needs)

Contact Information

First Name *REQUIRED

Last Name *REQUIRED

Mailing Address (Street) *REQUIRED

Mailing Address (Street) 2

City *REQUIRED

State *REQUIRED

Zip Code *REQUIRED

Phone Number (Cell) *REQUIRED

Phone Number (Home)

1ntokyn68mo2

Email Address

Secondary Contact Information

Secondary Contact Name

Phone numbers and addresses can change quickly. Please provide us a secondary or emergency contact so we can reach you.

Secondary Contact Relationship to You

Secondary Contact Phone Number

Demographic Information

Date of Birth *REQUIRED

Current Age *REQUIRED

Gender (optional)

Male
Female
Other

Race/Ethnicity (optional)

Asian/Pacific Islander
Black
Hispanic
Multiracial
Native American
Other
White

Are you a US Citizen, National or Permanent Resident Alien? *REQUIRED

How did you hear about Heart of Oregon Corps?

Have you ever been in a Heart of Oregon Corps Program before? *REQUIRED

If you answered YES, please name the Program, Year, and reason for leaving.

Education History

What is your high school education status? *REQUIRED

Currently attending high school
Dropped out of high school
Graduated high school or earned GED
Attending college
Some college

What school/program are you attending?

If currently attending high school or GED program:

What year did you earn your Diploma/GED?

If graduated from high school or GED program:

Which certification did you earn?

Regular High School Diploma
Modified High School Diploma
GED

Work History

Most Recent Employer

Dates of Employment

Skills Learned

Reason for Leaving

Personal Goals

Check the areas that are of interest to you while in program *REQUIRED

Gain Construction Skills
Gain Land Conservation Skills
Explore Career Options
Earn High School Credits
Complete GED
Complete Diploma
Prepare for College
Attend College

What are your goals after program completion? *REQUIRED

Return to High School for Diploma
Attend College/Vocational School
Find Full-Time Employment
Find Part-Time Employment
Not Sure

Motivational Statement

Tell us why you want to join a Heart of Oregon Corps program, and what you hope to learn or gain through your service

Certification

I understand that this application may be the first step in a longer enrollment process. That process may include a background check, drug test, interview, and/or additional paperwork.

Heart of Oregon Corps is a drug free workplace and does not permit the use of tobacco products, alcohol, or drugs in our programs.

I certify that all of the statements made in this application are true to the best of my knowledge. As a recipient of Federal financial assistance, Heart of Oregon Corps is prohibited from discriminating on the grounds of race, color, religion, gender, national origin, age, disability, political affiliation or belief, and against any beneficiary of programs on the basis of the beneficiary’s citizenship/status as a lawfully admitted immigrant authorized to work in the United States.

Heart of Oregon Corps’ YouthBuild project is funded by a grant awarded under the YouthBuild grant initiative, as implemented by the US Department of Labor’s Employment and Training Administration.

Alternative formats of this application are available upon request by contacting the Program Coordinator at Heart of Oregon Corps: 541-633-7834, info@heartoforegon.org.

Applicant Signature (type full name) *REQUIRED

Today's Date *REQUIRED

Online applicants under 18 will be required to obtain a parent/guardian signature during the application process

Parent/Guardian Signature (Type full name; if applicant is under 18)

Heart of Oregon Corps

Bend Headquarters

1291 NE 5th St.

Buildings A & B

Bend, OR 97701

p: 541-633-7834

f: 541-306-3703

CCB# 188805

Mailing Address

PO Box 279

Bend, OR 97709

HeartOfOregonCorps

heartofOregonCo

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