<p>Pennsylvania Campus Compact AmeriCorps*VISTA Program 2012-2013 Host Site Application: Cover Sheet Due Monday, January 9, 2012 @ 12pm</p><p>Submission Instructions a</p><p>All documents should be submitted as one (1) .pdf—with your institution’s name as the title—via email to [email protected]. Additionally, please send Part C: Host Site Application Concept Paper as a separate .pdf. Deadline: Monday, January 9, 2012 @12pm. (Note: This is a change in process from previous years). </p><p>Applicant Information a</p><p>Applicant Institution: </p><p>Program Name (If applicable): </p><p>VISTA Supervisor’s Name: </p><p>VISTA Supervisor’s Title: </p><p>Address: </p><p>Telephone: Fax: Email: </p><p>Completed Application Checklist:</p><p>Host Site Application Cover Sheet Part A: Sections I-V Part B: Logic Model, VISTA Assignment Description, & Performance Measures (Specific to each program area) Part C: Host Site Application Concept Paper Letter of Support from College/University President Letter(s) of Support from at least one community partner Resume of Supervisor</p><p>Proposed Project Focus Area: Select one of the following service areas by checking the corresponding box.</p><p>Improving academic achievement of at-risk K-12 students Increasing college access for at-risk high school students Increasing food access for low-income families </p><p>Pennsylvania Campus Compact * 1 College Avenue, Box 4508 * Grantham, PA 17027 * (717) 796-5072 * F (717) 796-5078</p>