Young Adult Service Communities (YASC) Application

Part I Application


Additional placements will be made on a rolling basis until all positions are filled.

   

Questions?

 

Please contact Rev. Mary Schaller Blaufuss, Executive for Volunteer Ministries

700 Prospect Ave. E, Cleveland, OH  44115-1100

Phone:  (216) 736 3214 or toll-free (866) 822-8224 ext. 3214
Fax: (216) 736-2294 *  Email: 
blaufusm@ucc.org
UCC Young Adult Service Communities do not discriminate against applicants on the basis of religion, race, color, national origin, sex, age, sexual orientation, or disabilities.

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YASC September 2014 - August 2015
  • Community Living
  • Hands-On Justice Advocacy/Service Opportunities
  • Leadership Development
  • Faith Conversations

Following submission of this part I application, you will receive by e-mail part II and forms for 3 references to complete.  If you do not have access to e-mail, please contact the UCC Volunteer Ministries Office for a printed copy of this application at 216 736-3216.

Application will be considered complete when parts I, II and reference forms have been returned to:  UCC Volunteer Ministries Office, 700 Prospect Avenue E., Cleveland, OH 44115 or completed, scanned and e-mailed to blaufusm@ucc.org. 

This application is not binding on either the applicant nor the office of UCC Volunteer Ministries.

    This introductory application allows Volunteer Ministries staff to get to know the experiences and skills you offer for a volunteer placement.  Completion of this form begins the application process but does not commit you to participation nor guarantee placement.  Volunteer Ministries staff will electronically send you the second part of the application and forms for written references.  Application will be considered complete when parts I, II and reference forms have been returned to:

    Volunteer Ministries
    700 Prospect Avenue E
    Cleveland, OH 44115
    Fax:  216.736.2294
    Email:  blaufusm@ucc.org or adamst@ucc.org 

       
       
    Title 
    Name
    Address
    City
    State
    Zip Code
    Country
    Phone
    Cell Phone
    Do you use Texting?

     

    Fax
    E-mail Address
    Date of Birth (mm/dd/year)
    City of Birth
       
    EMERGENCY CONTACT (Person who can always reach you)
       
    Name 
    Address
    City
    State 
    Zip Code 
    Country
    Phone
    Cell Phone
    Fax
    E-Mail
       
    Your Availability for  a Placement with a Young Adult Service Community

     September 2013 - August 2014 Young Adult Service Communities
     
       
    Types of Skills and Experience You bring (Check all that apply) 
    Languages Spoken or Written 
    Your Experience: 

    Your Experience: 
     

    Your Experience:

     

    Your Experience:  

    Your Experience:  

    Your Experience:  

    Class: 
    Your Experience: 
    Your Experience: 
    Your Experience: 
    Your Experience: 
    Your Experience: 
    Other Skills ~ Please list:
       
     Possible Service Settings 
    (
    Indicate Interest by 1, 2, 3, 4, 5 with 1 as little interest and 5 as great interest.)
       
    Immigration & Border Ministries    
    Elderly
    Homeless Shelters 
    Inner City Ministries
    Direct Social Service 
    Worker's Rights 
    Community Organizing 
    Children 
    Food Programs 
    UCC wider church
    Other 
    Please Explain:

       
       
    UCC Young Adult Service Communities in Network
       
    Locations in Order of Preference:   
       
       
    Keystone Congregational UCC/All Pilgrims Christian, Seattle WA September 2014 - August 2015
    Justice Advocacy Settings:  Justice Advocacy Agencies and intensive justice leadership training.  
       
    Old First Reformed UCC, Philadelphia, PA 


    September 2014 - August 2015


    Justice Advocacy Setting: P.O.W.E.R. (Faith-based Community Organizing)
     
       
       
    Pilgrim UCC, Carlsbad, CA September 2014- August 2015


    Justice Advocacy Setting:  J.O.B. (Faith-based Community Organizing)
     
       
       
    *Westmoreland Congregational UCC, Bethesday, MD (Applications Closed) September 2014 - August 2015
    Direct Service Settings:  Old First Wellspring Program (Food and Clothing Cupboard), Broad Street Ministry (Food Program),  Bethesda Project Homeless Shelter  
    "Westmoreland Volunteer Corps" Setting:  Washington, DC - Case Workers fields of health care, homeless populations, social services.     
    ** WVC has a separate application procedure.  Please visit www.westmorelanducc.org   
       
      No Preference September 2014 - August 2015
       
    How did you learn or hear about this program?
       
           
    SECTION MENU
    CONTACT INFO

    Rev. Mary Schaller Blaufuss
    Executive for Volunteer Ministries
    Global Sharing Of Resources
    Wider Church Ministries
    700 Prospect Ave.
    Cleveland,Ohio 44115
    216-736-3214
    blaufusm@ucc.org