Chi Rho       Corps Member Application

Are you graduating soon?

Is your future not quite mapped out yet?

Do you ever feel a real desire to serve others?

Challenge Yourself!

Beginning next August, you could put your best ideals into practice and become a member of Chi Rho Catholic
Service Corps.  Working with Chi Rho, you can serve others full time for one year, keep your career plans
right on track, and have the experience of a lifetime!

     As a Chi Rho corps member, you will work full time in service to the inner city poor of Connecticut. You will
be making a big difference in their lives as well as your own!  You will be helping to improve the lives of
refugees, the homeless, persons with AIDS, schoolchildren, and others who need your help.  We have a wide
variety of positions which are just waiting for your talents, creativity, and enthusiasm.

     While serving, you will live in a community with other corps members.  Full room, board, and health
insurance are provided, plus you will earn a weekly stipend and a year end bonus.

     Also, through a combination of speakers, readings, films, and group discussions, we will openly examine
important questions regarding service to others, priorities in life, and the role of Christ and the Catholic
Church in today’s world.
     
     We have a host family program which provides each corps member to interact with people from beyond
the immediate Chi Rho community.

     We also offer help with career decisions through our mentoring program with area professionals.

     You will be able to take advantage of numerous recreational, cultural and spiritual opportunities as well.

     You can even take one course per semester for credit at an area university for free!
     If this sounds like the kind of experience you are looking for, then fill out this application form and return it
to us!



Chi Rho Corps Member Application
Please print clearly or type.  Please answer all questions.

________________________________________________________________________
Name (last, first, middle initial)

________________________________________________________________________
Sex                        Social Security Number                           Date of Birth (mm/dd/yyyy)

________________________________________________________________________
Current Address (or college address)                                                   City, State, Zip

________________________________________________________________________
Telephone                                Cell phone                                E-mail

________________________________________________________________________
Permanent Address (or parent’s address)                                           City, State, Zip

________________________________________________________________________
Telephone

________________________________________________________________________
Parents’ Names

________________________________________________________________________
Parents’ Address(es)                                                                   City, State, Zip

________________________________________________________________________
Emergency Contact Person (and relationship)                                       Telephone

________________________________________________________________________
Personal Physician

________________________________________________________________________
Physician’s Address                                                                   City, State, Zip


Are there any medical conditions or health problems which might effect your service or place of assignment?  
(These include physical handicaps, chronic illnesses, etc).

Y _____  N _____  If yes, please explain:______________________________________

Who is your current medical insurance provider? ________________________________

Do you have a driver’s license? Y ____  N ____

Will you bring a car? Y ____  N ____

Do you have any financial, family, or personal obligations that would interfere with your full year of service
work with Chi Rho? Y ____  N ____  If yes, please explain.

Please list all schools attended since and including high school.  Begin with the most recent.

School/ City & State        Major/ Minor        Degree        Date Rec’d        Dates Attended

                             

                             

                             

                             

                             


Please list any foreign languages that you speak.

Language        Years        Speaking Ability

                             
                             
                             
                             


References…
Included are one self-reference form and three personal reference forms.  Complete the self-reference form
and return it with your application.  Give one personal reference form from each to an employer, a teacher,
and a religious person (sister, priest, etc.) who knows you well.  Ask each to mail the completed form directly to
Chi Rho (our address is on the form).

Resume…
Please include with your application a copy of your resume.  Should you be accepted as a corps member,
your resume will be sent to your potential employment supervisor.

Questions…
Please type your responses to the following questions and submit with your application.

Detail Questions:
Describe any significant cross-cultural experiences you have had, through travel abroad or through work,
school, church or community activities.

Describe any volunteer work you have done, including high school.

What do you like to do in your spare time?  Include sports, hobbies, musical instruments, and other special
interests.

Short Answer Questions:
Why do you want to become a member of Chi Rho?

What personal goals can you achieve through a year of service?

How would you describe the role of Catholic faith in your life?

Essay Questions (approx. 250 words each):
Who is someone you particularly admire, and why?

What does the word ‘service’ mean to you?

What are the most important questions in your life right now, and why?

What’s next?
Once we receive your completed application (this packet, self reference, resume, question answers, and three
personal references) we will contact you regarding a personal interview.

Our year long program begins in August.  There is no specific deadline for your application, but we
recommend you submit it by May 1st.  The sooner you complete it, the better your chances for acceptance.

If you have any questions, concerns, or comments, please call us.

Chi Rho Catholic Service Corps
9 Eld Street
New Haven, CT 06511

Ph. 203-848-0176