Community Impact Accelerator Fellowship

Application

Thank you for your interest in the Community Impact Accelerator Fellowship program, from Intend Indiana and Prosperity Indiana.

Please complete the application below to apply for the program.

Review Position Description

Community Impact Fellowship — Application for Employment

A program of Prosperity Indiana & Intend Indiana.

"*" indicates required fields

1About You

2Position

3Background

4References & Alignment

5Sign & Submit

This field is for validation purposes and should be left unchanged.

Personal Information

Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Email Address*

Enter Email Confirm Email

Preferred Phone Number*

Social Media Handles

LinkedIn, X, Facebook/Instagram, TikTok

Are you eligible to work in the U.S.?*

Yes

Are you at least 18 years or older?*

Yes

Have you ever been terminated from employment or asked to resign by an employer?*

Yes

Please provide company names and details*

Can you work a flexible schedule, including occasional weekends?*

Yes

Are you able to perform the essential functions of the job for which you are applying, with or without a reasonable accommodation?*

Yes

Employment Desired

Can you start in-person work in January 2027?*

Yes

Community Impact Fellowship Location Preference

Rank in order of preference

Elkhart
Huntington
LaPorte/Michigan City

Are you willing to relocate, if necessary, to complete this embedded community fellowship opportunity?*

Relocation may be required if an assigned community cannot be reached in a reasonable commute.

Yes

Maybe

Are you currently employed?*

Yes

May we inquire of your present employer?*

Yes

Referral Source

How did you hear about this fellowship program?*

Referral

Other

Have you ever worked for Prosperity Indiana, Intend Indiana, or the Indiana Economic Development Corporation (IEDC)?*

Yes

Please explain your work and the reason for your departure.*

Do you have immediate relatives who work for Prosperity Indiana, Intend Indiana, or IEDC?*

Yes

If yes, who?*

Education History

Complete if applicable. If not applicable, enter "N/A".

Education

Level (Graduate, College/University, Trade/Business)

School name &location

Degree received

Subjects studied / major

Employment History

Include your last five (5) years of employment history, including periods of unemployment, starting with the most recent and working backwards. Incomplete information could disqualify you from further consideration.

Most recent employer

From*

To*

If currently working here, please put today's date.

Employer Name*

Employer Phone

Your Job Title*

Employer Physical Address*

Immediate Supervisor & their Job Title*

Brief summary of the nature of your work and job responsibilities*

Reason for leaving*

Add another employer?*

Yes

Employer 2

From*

To*

Employer Name*

Employer Phone*

Job Title*

Employer Physical Address*

Immediate Supervisor & their Job Title*

Brief summary of the nature of your work and job responsibilities*

Reason for leaving*

Add another employer?*

Yes

Employer 3

From*

To*

Employer Name*

Employer Phone*

Your Job Title*

Employer Physical Address*

Immediate Supervisor & their Job Title*

Brief summary of the nature of your work and job responsibilities*

Reason for leaving*

Add another employer?*

Yes

Employer 4

From*

To*

Employer Name*

Employer Phone

Your Job Title*

Employer Physical Address

Immediate Supervisor & their Job Title*

Brief summary of the nature of your work and job responsibilities*

Reason for leaving*

Additional Qualifications

Do you have any special skills, experience, and/or training that would enhance your ability to perform the fellowship position?*

Yes

If yes, please explain.*

Professional References

Names of three persons not related to you, whom you have known at least three (3) years. You will be notified before references are contacted.

Reference 1

Name*

First Last

Company*

Number of Years Acquainted*

Email*

Phone*

Address

Street Address Address Line 2 City State ZIP Code

Reference 2

Name*

First Last

Company*

Number of Years Acquainted*

Email*

Phone*

Address

Street Address Address Line 2 City State ZIP Code

Reference 3

Name*

First Last

Company*

Number of Years Acquainted*

Email*

Phone*

Address

Street Address Address Line 2 City State ZIP Code

Alignment

Describe your connection to the communities listed above. If you are matched to a new community, how would you build trusted local relationships?*

2000 character limit

What do you hope to gain from this fellowship, and how do you hope the experience will support your professional growth?*

2000 character limit

Why is it important to invest in the sustainability of Hoosier communities through community economic development?*

2000 character limit

What unique or personal strengths and perspectives will you bring to this fellowship opportunity?*

2000 character limit

Resume and cover letter*

PDF or Word, up to two files, 5 MB each.

Drop files here or

Accepted file types: pdf, doc, docx, Max. file size: 5 MB, Max. files: 2.

Acknowledgment

Please read carefully before signing.

I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for Prosperity Indiana to hire me. If I am hired, I understand that either Prosperity Indiana or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of Prosperity Indiana has the authority to make any assurance to the contrary.

I attest with my signature below that I have given to Prosperity Indiana true and complete information on this application. No requested information has been concealed. I authorize Prosperity Indiana to contact references provided for employment reference checks. If any information I have provided is untrue, or if I have concealed material information, I understand that this will constitute cause for the denial of employment or immediate dismissal.

Agreement*

I have read and agree to the statements above.

Signature*

Type your full legal name. This serves as your electronic signature.

Date*

This application is valid for 60 days from the date above.

Prosperity Indiana is an equal opportunity employer. Prosperity Indiana does not discriminate in employment with regard to race, color, religion, national origin, citizenship status, ancestry, age, sex, sexual orientation, marital status, physical or mental disability, military status or unfavorable discharge from military service or any other characteristic protected by law.