Member Screening/interview Evaluation Form printable pdf download

Member Screening/Interview Evaluation Form

Applicant ________________________________________

Date: _____________________________

Interviewed by ____________________________________

Time of Interview:___________________

INTERVIEW

⁯ Yes ⁯ No Did you receive the pre-interview packet?

⁯ Yes ⁯ No Do you have any questions? What position are you interviewing for?__________________________________

⁯ Yes ⁯ No Where did you hear about our program? ________________________________________________________

⁯ Yes ⁯ No Have you ever been an AmeriCorps member before? Where? ____________________________________

⁯ Yes ⁯ No Given your knowledge of the position, are there any tasks that you could not perform?

RATING SCALE

1 = Not a good match

2 = Poor

3 = Average

4 = Good

5 = WOW!

1. _________ Explain why you are interested in being a member of our team?

2. _________ Please share with us how your background has prepared you for this position. Specifically address any skills you have

acquired that are applicable to the following FOUR areas (I can repeat these at any time):

Working in teams:

Working with students (IP); outdoors (FT):

Working with community groups:

Coordinating and/or organizing:

3. _________ We realize our program can be challenging – challenging to different people for different reasons. What challenges do you

think you will face in this position and how will you address them?

4. _________ (Please indicate that this is a situational question)

Field Team. Your team is on a salmon recovery project and is working in groups of three. One member of your group is

sitting on the bank while you and the other team member are hauling logs, shoveling gravel, and standing knee-deep in

cold water. How do you address this situation?

Individual Placement. (Tailor this question based on what position they are interested in) Your placement is in a middle

school. You took this placement because there was a great deal of focus on “at-risk” youth (e.g., working with ESL

students, truancy, and a naturescaping project). For the last two weeks most of your time has been spent on recess duty

and making phone calls and copies for various teachers. How do you address this situation?

5. _________ Name a time when you experienced conflict on a job. Please be specific and tell us how you dealt with it.

6. _________ What does community service mean to you? Please describe your experience working with diverse groups of people.

Contributed by NWSA (Northwest Service Academy, Portland, OR). An EnCorps resource. Please retain the original program attribution when adapting or

using this resource. Rev. June 2007.

Member Screening/interview Evaluation Form