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Kupu ʻĀina Corps Program

HOST SITE APPLICATION FORM

Mahalo for your interest in applying to be a Kupu ʻĀina Corps (KAC) host site! This program was created to provide paid, career building experiences for young adults in sustainability related professions. Kupu's objective with the KAC program is to increase the capacity of the Hawaiʻi green jobs sector by supporting emerging and resilient green industries. By participating as a host site, organizations can increase their capacity at a highly subsidized rate through staffing resources provided by Kupu. Please read the full description of this program at our website.

If you have any questions, please contact us at (808) 735-1221 ext. 2012 or via email at kac@kupuhawaii.org.

*Before filling out this application, please make sure you have performed all updates on your web browser.

Host Site Information & Requirements

Sites may host one or more individual participants.

If your organization only has one direct supervisor overseeing the requested participants, you may submit one application form. If your organization is requesting multiple participants and they will be overseen by separate supervisors, each direct supervisor at your organization needs to submit their own application form.

You are required to submit an Emergency Action Plan with this application. A sample or template you may view as an example can be found here.

After completing this application, selected sites will need to sign a Master Agreement and Statement of Work Addendum to proceed with this Kupu program.

I have read, understood, and can meet the host site description and requirements written here and on the Kupu website .

(Initial)

Organization & Site Information

Name of Organization or Agency:

Organization's Full Legal Name:

If you are a federal agency, please contact us at kac@kupuhawaii.org.

Is your organization a subsidiary of another entity or agency? If so, please tell us the name of the Lead/Parent Organization:

e.g., Department of Land & Natural Resources, Department of Education, U.S. National Park Service, U.S. Fish and Wildlife

Organization Category:

Island where participant(s) will be based:

If other, please specify:

Host Site Section/Program/Location Name:

Enter the PROPER NAME of the specific program, section, or site where Kupu participants will serve (e.g., Waipa Valley, Kaua'i National Wildlife Refuge, Sea Urchin Hatchery, Kawainui Baseyard, Visitor's Center).

What is the physical location (e.g., baseyard, office) where the participant(s) will be spending most of their time? If you are unable to provide the address, you must enter the GPS coordinates, mile marker, or tax key number.

Enter the 5 digit ZIP code of the address or location you wrote above.

If Kupu needs to send gear or supplies for the participant(s), please enter a staff name and mailing address for where those items should be sent.

Have you previously hosted a participant from Kupu?

YesNo

Does your host site utilize Altres for Human Resources issues?

YesNo

Primary Point of Contact for Organization

Organization POC (Full First Name)

Organization POC (Full Last Name)

Preferred Name

Position Title

Work Email

You must use this individual's direct work email address. Do not use a group email used by multiple staff for your organization.

Office Phone Number

Cell Phone Number

Fax Number

Address (Line 1)

Address (Line 2, if applicable)

City

State / Province / Region

Postal / Zip Code

Country

Which authorization level does the Organization POC have for approval of the participant's time sheet?

Finance Contact for Organization

Finance Contact (Full First Name)

Finance Contact (Full Last Name)

Preferred Name

Position Title

You must use this individual's direct email address. Do not use a group email used by multiple staff for your organization.

Office Phone Number

Cell Phone Number

Fax Number

Address (Line 1)

Address (Line 2, if applicable)

City

State / Province / Region

Postal / Zip Code

Country

Host Site Contract Information

What is the official name or title that should be written in the Master Agreement (MA) and Statement of Work Addendum (SOW) contracts for your organization/site if you are selected?

Your entry here will be auto-populated into these documents, so please verify their accuracy and spelling before submitting your application.

Who is responsible for signing the MA and/or SOW contracts for this site? (select all that apply)

Organization POCFinance ContactDirect SupervisorOther

MA/SOW Contact Information

MA/SOW Contact (Full First Name)

MA/SOW Contact (Full Last Name)

Preferred Name

Position Title

Office Phone Number

Cell Phone Number

Fax Number

Address (Line 1)

Address (Line 2, if applicable)

City

State / Province / Region

Postal / Zip Code

Country

Describe any specific requirements for your organization in regards to the signing of the MA & SOW contracts. If there are no special requirements, write N/A.

How should payments be handled?

Work ContractInvoicePurchase OrderOther

If you selected other, please specify:

Background & Impact

Due to data limitations, please do NOT use any rich text formatting (i.e., bullet points) in your responses.

1. Provide a brief description of your organization that can be published to give out to applicants as an opportunity to learn more about your organization. Please do not provide any website urls in your answer.

2. What do you and your organization hope to gain from participating in this program? What do you hope participants will gain from this program and working with your organization?

3. What are the desired outcomes and overall benefits or impact of the direct services this position would be providing to the community and environment?

4. Which work categories best describe the type of position you would offer? (choose up to 3)

Agriculture & Food SystemsAquatic Resource ManagementCapacity Building SupportCesspool ConversionClimate AdaptationCommunity Outreach & EducationEcotourismEnvironmental Technologies & Renewable EnergyFence MaintenanceGIS/GPSInvasive Species RemovalLab or NurseryNative Hawaiian Cultural StewardshipNative Plant ConservationNative Wildlife ConservationSustainable InfrastructureSustainable Product DevelopmentTrail RestorationWatershed Management

5. Do you have plans to hire participants once your KAC program participation ends? If so, how many individuals do you anticipate hiring?

6. Categorize the approximate percentages this position will spend working in each of the following categories. The sum of your entries must total 100%.

Climate Adaptation

Environmental Education & Community Outreach

Environmental Technologies

Habitat Restoration

Mobilizing Community Volunteers in Environmental Projects

Native Planting

Sustainable Agriculture

Trail Maintenance/Restoration

Other

Total

If you entered an amount greater than zero for "Other" above, please specify the type/category of service. Otherwise type "n/a".

7. List the name(s) of the management area(s) and the number of acres that will benefit from any service completed. If not applicable to your site, please enter n/a.

8. Do you have anyone you would like to recommend for this position? If possible, please list their full name.

Site Details

Due to data limitations, please do NOT use any rich text formatting (i.e., bullet points) in your responses.

1. Will participants work in remote areas where cell phone service communication is unavailable?

YesNo

If you selected yes, describe the emergency communication tools that are available for participants working in remote areas.

2. Attach your site's Emergency Action Plan (PDF format only). Click here to see a sample template.

3. Does your host site require the member to be vaccinated?

YesNo

Please select the COVID-19 vaccination requirement for participants at your site:

4. Attach a copy of your site's COVID-19 policies and risk mitigation plan if applicable. (PDF format only)

5. Is there anything specific about your site or projects that need special consideration (i.e., use of dangerous pesticides, extensive helicopter use, heavy machinery operation)?

YesNo

6. Please describe:

7. Since you chose yes above, would your site be able to provide special training or certifications for the participant(s)?

YesNo

Individual Participants

Please provide Kupu with the position description details for each role being offered to the participants. Please note that the number of participants you request cannot be guaranteed. Positions that exceed 20 hours of work per week are considered full-time.

IMPORTANT: The Direct Supervisor will need to be the same for all position descriptions for the individual participants requested at your site. If there will be different supervisors per participant/position description, please fill out additional host site application forms for your organization/site.

How many full-time participants would you like to host at your site (40 hours/week)?

How many part-time participants would you like to host at your site (20 hours/week)?

You have requested to host more than one individual participant. Will all of the participants at this site have the same position title, description, and requirements? If not, you may complete additional Position Description entries on this application by selecting no below (up to 5 total).

YesNo

How many position description sections will you need to fill out?

Position Description 1

Due to data limitations, please do NOT use rich text formatting (i.e., bullet points) in your responses.

1. Position Title:

At what hourly rate will the participant working under this position title be paid? Click here to see our hourly rate guidance document.

$16 per hour$18 per hour$20 per hour

2. Responsibilities and Duties: Provide a brief description of the role, how it fits into the overall organization, and what success in the position looks like. Include how many of your requested participants this PD would apply to, as well as the essential duties required to carry out this position, in order of importance.

3. Qualifications: List the qualifications that would be beneficial for someone to fill this position. Include the level of experience required (i.e., entry level, some experience required, degree required).

4. Level of Education Preferred:

High School DiplomaAssociate's Degree or Trade School DiplomaBachelor's DegreeMaster's DegreeNo Preference

5. Site Environment: Will the participant primarily work in an outdoor or indoor setting?

OutdoorIndoor

Will this position be performed remotely (i.e., the participant will work from home)?

Yes, position will be performed remotely.No, position will not be performed remotely.

Describe the typical setting and anything that stands out such as extreme weather or terrain.

6. Will the participants be required to camp for any period of time?

YesNo

7. Schedule: List the typical hours and days, field schedule, and when camping may be involved.

8. Supervision & Training Provided: Explain the level of supervision and the mentorship the individual in this position will receive. During the course of the program, will the participant gain any new skills that will increase their prospects of employment? List any certifications, trainings, professional development opportunities, workshops, etc. that will be provided by your site.

Position Description 2

Use this section to provide a second position description for any participants that will have a different role, title, and requirements.

Due to data limitations, please do NOT use any rich text formatting (i.e., bullet points) in your responses.

1. Position Title:

At what hourly rate will the participant working under this position title be paid? Click here to see our hourly rate guidance document.

$16 per hour$18 per hour$20 per hour

4. Level of Education Preferred:

High School DiplomaAssociate's Degree or Trade School DiplomaBachelor's DegreeMaster's DegreeNo Preference

5. Site Environment: Will the participant primarily work in an outdoor or indoor setting?

OutdoorIndoor

Will this position be performed remotely (i.e., the participant will work from home)?

Yes, position will be performed remotely.No, position will not be performed remotely.

Describe the typical setting and anything that stands out such as extreme weather or terrain.

6. Will the participants be required to camp for any period of time?

YesNo

7. Schedule: List the typical hours and days, field schedule, and when camping may be involved.

Position Description 3

Use this section to provide a third position description for any participants that will have a different role, title, and requirements.

Due to data limitations, please do NOT use any rich text formatting (i.e., bullet points) in your responses.

1. Position Title:

At what hourly rate will the participant working under this position title be paid? Click here to see our hourly rate guidance document.

$16 per hour$18 per hour$20 per hour

4. Level of Education Preferred:

High School DiplomaAssociate's Degree or Trade School DiplomaBachelor's DegreeMaster's DegreeNo Preference

5. Site Environment: Will the participant primarily work in an outdoor or indoor setting?

OutdoorIndoor

Will this position be performed remotely (i.e., the participant will work from home)?

Yes, position will be performed remotely.No, position will not be performed remotely.

Describe the typical setting and anything that stands out such as extreme weather or terrain.

6. Will the participants be required to camp for any period of time?

YesNo

7. Schedule: List the typical hours and days, field schedule, and when camping may be involved.

Position Description 4

Use this section to provide a fourth position description for any participants that will have a different role, title, and requirements.

Due to data limitations, please do NOT use any rich text formatting (i.e., bullet points) in your responses.

1. Position Title:

At what hourly rate will the participant working under this position title be paid? Click here to see our hourly rate guidance document.

$16 per hour$18 per hour$20 per hour

4. Level of Education Preferred:

High School DiplomaAssociate's Degree or Trade School DiplomaBachelor's DegreeMaster's DegreeNo Preference

5. Site Environment: Will the participant primarily work in an outdoor or indoor setting?

OutdoorIndoor

Will this position be performed remotely (i.e., the participant will work from home)?

Yes, position will be performed remotely.No, position will not be performed remotely.

Describe the typical setting and anything that stands out such as extreme weather or terrain.

6. Will the participants be required to camp for any period of time?

YesNo

7. Schedule: List the typical hours and days, field schedule, and when camping may be involved.

Position Description 5

Use this section to provide a fifth position description for any participants that will have a different role, title, and requirements.

Due to data limitations, please do NOT use any rich text formatting (i.e., bullet points) in your responses.

1. Position Title:

At what hourly rate will the participant working under this position title be paid? Click here to see our hourly rate guidance document.

$16 per hour$18 per hour$20 per hour

4. Level of Education Preferred:

High School DiplomaAssociate's Degree or Trade School DiplomaBachelor's DegreeMaster's DegreeNo Preference

5. Site Environment: Will the participant primarily work in an outdoor or indoor setting?

OutdoorIndoor

Will this position be performed remotely (i.e., the participant will work from home)?

Yes, position will be performed remotely.No, position will not be performed remotely.

Describe the typical setting and anything that stands out such as extreme weather or terrain.

6. Will the participants be required to camp for any period of time?

YesNo

7. Schedule: List the typical hours and days, field schedule, and when camping may be involved.

Individual Participants - Direct Supervisor's Contact Information

Direct Supervisor (Full First Name)

Direct Supervisor (Full Last Name)

Preferred Name

Position Title

You must use this individual's direct email address. Do not use a group email used by multiple staff for your organization.

Office Phone Number

Cell Phone Number

Fax Number

Which authorization level does the Direct Supervisor have for approval of the participant's time sheet?

Will the Direct Supervisor be available to host and oversee all requested individual participants for the entirety of the designated program timeframe? Please explain any conflicts and ensure the contact information for the Back-Up Supervisor is provided below.

Would you like to provide the contact information for the Back-Up Supervisor of the individual participants at this time?

Individual Participants - Back-Up Supervisor's Contact Information

Back-Up Supervisor (Full First Name)

Back-Up Supervisor (Full Last Name)

Preferred Name

Position Title

You must use this individual's direct email address. Do not use a group email used by multiple staff for your organization.

Office Phone Number

Cell Phone Number

Fax Number

Which authorization level does the Back-Up Supervisor have for approval of the participant's time sheet?

Host Site Acknowledgments

In order to process your application, your organization/site must acknowledge and agree to the written statements below. Please read carefully.

Our host site will provide hands-on learning experiences and service in the fields of conservation, education, agriculture, climate adaptation, environmental technologies, cesspool conversion, or sustainability.*

Our host site understands that the Kupu program will do its best to match participants and sites, but there is no guarantee of selection.*

If selected, our host site agrees to assist in recruiting for the position(s).*

A meaningful term of service with proper mentoring and supervision will be provided for all participants placed at my organization/site.*

A safe learning environment will be provided for all participant(s) placed at my organization/site.*

If selected, I certify my organization/agency can accommodate both financially (unless otherwise noted) and operationally the total number of participants and teams requested.*

This application has been completed by:

Organization POCDirect SupervisorBack-Up SupervisorFinance ContactMA/SOW ContactOther

Please provide your full name:

Email:

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Contact Information

Kupu ʻĀina Corps Program HOST SITE APPLICATION FORM

Kupu ʻĀina Corps Program

HOST SITE APPLICATION FORM