OMB control number

AmeriCorps Member Application, Enrollment, and Exit Forms

OMB 3045-0054 · CNCS.

OMB 3045-0054

This information collection is a revision of AmeriCorps Member Application, Enrollment, and Exit Form. Applicants will respond to the questions included in this information collection tool to apply to serve as AmeriCorps members, enroll in the National Service Trust, and exit their term of service.

The latest form for AmeriCorps Member Application, Enrollment, and Exit Forms expires 2028-05-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form 1 AmeriCorps Member Application, Enrollment, and Exit Form Form and Instruction
30-Day_04-16-25_90 FR 15979.pdf Supplementary Document
60-Day_12-30-2024_89 FR 106447.pdf Supplementary Document
National and Community Service Act of 1990.pdf Supplementary Document
Member Application SSA_For Upload.docx Supporting Statement A
AmeriCorps Member Application, Enrollment, and Exit Form Form and Instruction

All Historical Document Collections

202411-3045-001	Revision of a currently approved collection	2025-04-16
202202-3045-001 Approved with change	Revision of a currently approved collection	2022-02-09
201812-3045-001 Approved without change	Revision of a currently approved collection	2018-12-13
201510-3045-001 Approved without change	Reinstatement with change of a previously approved collection	2015-10-02
201212-3045-001 Approved without change	No material or nonsubstantive change to a currently approved collection	2012-12-07
201204-3045-002 Approved without change	Extension without change of a currently approved collection	2012-04-27
201101-3045-003 Approved without change	No material or nonsubstantive change to a currently approved collection	2011-01-24
200901-3045-001 Approved without change	Revision of a currently approved collection	2009-01-30
200510-3045-003 Approved without change	Revision of a currently approved collection	2005-10-28
200305-3045-004 Approved without change	No material or nonsubstantive change to a currently approved collection	2003-05-22
200208-3045-001 Approved with change	Revision of a currently approved collection	2002-08-07
199904-3045-001 Approved without change	New collection (Request for a new OMB Control Number)	1999-04-09