Please complete this form to be considered for a Virtual Service opportunity
 
First Name:*
 
 
Middle Name (If you don’t have a middle name enter NMN):*
 
 
Last Name:*
 
 
Email Address:*
 
 
Mobile Phone:*
 
 
Home of Record (HOR)/Permanent Address:
 
Street Address*
 
 
City*
 
 
State*
 
 
Zip/Postal Code*
 
 
If your name has changed since you served as a Peace Corps Volunteer (PCV), please list the name you used during service:
 
 
You may express interest in up to two opportunities (If you would like to review the available SoVES they are linked to the Virtual Services Pilot page.):
 
Country of Interest (Please note: RPCVs are only eligible to express interest in opportunities from their country of PCV or PCRV service):*
 
 
Reference number of the Statement of Virtual Engagement (SoVE) for which you would like to be considered:*
 
 
Confirm that you are available to engage 5-15 hours per week on the tasks outlined in the SoVE and able to meet at the meeting times suggested by HC Partners:*
 
 
Describe your technical skills, experience, and education in the areas outlined in the essential and desired qualifications sections of the first SoVE for which you would like to be considered. (1500 characters maximum including spaces)*
 
 
Virtual service requires strong intercultural skills such as flexibility, strong cross-cultural agility, high tolerance for ambiguity, ability to work independently, resourcefulness, and creativity. Please describe how you have demonstrated these traits in your work. (1500 characters maximum including spaces)*
 
 
Describe your motivation for participating in the Virtual Service Pilot. (1500 characters maximum including spaces)*
 
 
Second Statement of Virtual Engagement (SoVE) for which you would like to be considered (optional):
 
Second Country of Interest (Please note: RPCVs are only eligible to express interest in opportunities from their country of PCV or PCRV service):
 
 
Reference number of second SoVE for which you would like to be considered:
 
 
Confirm that you are available to engage 5-15 hours per week on the tasks outlined in the SoVE and able to meet at the meeting times suggested by HC Partners:
 
 
Describe your technical skills, experience, and education in the areas outlined in the essential and desired qualifications sections of the second SoVE for which you would like to be considered. (1500 characters maximum including spaces)
 
 
Virtual service requires strong intercultural skills such as flexibility, strong cross-cultural agility, high tolerance for ambiguity, ability to work independently, resourcefulness, and creativity. Please describe how you have demonstrated these traits in your work. (1500 characters maximum including spaces)
 
 
Describe your motivation for participating in the Virtual Service Pilot. (1500 characters maximum including spaces)
 
 
Upload your resume entitled ‘Last name, First name_VSP resume’ that demonstrates your experience and relevant qualifications to complete the listed tasks and language level (if requested) detailed in the SoVE:*
 
 
Provide one professional reference, preferably from a Peace Corps staff member, supervisor or counterpart or someone who has supervised your work in a cross cultural setting and include the following details:
 
Reference Full Name*
 
 
Reference Email Address*
 
 
Reference Phone Number*
 
 
Please provide an update on your legal status since your Completion of Service (COS). If you reply “Yes” to any of the following questions please provide any pertinent detail. You may also be contacted with a request for further information:
 
Since your COS, have you been arrested, charged, cited, or convicted of any offense? Exclude minor traffic violations, traffic citations, or parking tickets less than $300.*
 
 
If you answered "Yes" please provide any pertinent detail:
 
 
Since your COS, have you become involved in any court proceedings (civil or criminal) that will require your participation (as a plaintiff, defendant, or witness) during the time you would be participating in the Virtual Service Pilot Program?*
 
 
If you answered "Yes" please provide any pertinent detail:
 
 
Since your COS, have you or a family member been employed by or connected with an intelligence agency, or engaged in intelligence activity or related work?*
 
 
If you answered "Yes" please provide any pertinent detail:
 
 
By submitting this form, I certify that all of the statements made are true, correct, and complete to the best of my knowledge and are made in good faith. I understand that if I fail to disclose any required information about my legal history – including expunged or sealed cases – or drug/alcohol behavior, the Peace Corps may disqualify me from the Virtual Service Pilot.