Project MI CASA at UNCW Nomination Form 2013 – 2014
Student Nomination Criteria
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Must be a rising 11th grade Hispanic student
Must have demonstrated on-going commitment to attending a post-secondary school.
Must have satisfactory academic transcripts, discipline records and course selections.
Must be U.S. citizen or legal permanent resident
Student Nominee: _____________________________________
School: _______ ____________________________________
Address: ______________________________________________________________
Nominating Teacher: __ _______________ Core Subject: ______ ___________
E-mail address: ___________________________Phone: ___________
Reasons for Nominating this student: ______________________________________
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**Please email this form to micasa@uncw.edu within 2 weeks of receipt.
Based on your knowledge of the applicant, please rate the student’s characteristics and
academic skills.
1-Below Average
2-Average
3-Above Average
CHARACTERISTICS
Academic Achievement
Math Skills
Reading Skills
Study Skills
Writing Skills
Use of Time
Responsibility
Potential for Growth
Oratory Skills
Enthusiasm
Honesty/ Integrity
4-Outstanding
N/O-No Observation
CHARACTERISTICS
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Organizational Skills
Attendance
Self-motivation
Peer Relations
Respect for Authority
Leadership Potential
Creativity
Extracurricular Involvement
Concern for Others
Self-Esteem
Self Discipline
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From this point on, ONLY the student completes the remaining pages
UNCW MI CASA Mentee Contract
[“We do these things] not only because they are easy, but because they are hard, because that goal will serve to
organize and measure the best of our energies and skills, because that challenge is one that we are willing to
accept, one we are willing to postpone, and one which we intend to win, and others, too”.
–JFK
Background: MI CASA (Mentors Initiating Community Action, Support and Advocacy) mentoring
program is an organization involved UNCW faculty members and undergraduates. MI CASA is designed
to expand the educational opportunities for Latino students in Pender and New Hanover Country High
Schools. MI CASA is a comprehensive support program that provides mentoring, college prep, tutoring,
community service projects, and cultural enrichment. These components help prime participants to
become compelling candidates for college admission.
The program will change and grow with your involvement and contributions. As a mentee, you are
required to make a great commitment to working towards your future and we hope that MI CASA will
make a lasting and positive difference in your life.
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I will attend all MI CASA events
If I absolutely cannot attend an event, I will contact both the Community Liaison and my UNCW
Mentor at least 24 hours beforehand.
I will not let transportation problems cause me to miss an event (let us know!).
I will be in contact with my mentor weekly via e-mail or phone.
I will work with my mentor and complete all assignments.
I will attend all sessions.
If I am struggling with a class (making below a B), I will seek tutoring.
I will take the PSAT and the SAT/ACT.
I will plan my courses with input from my UNCW mentor and/or Community Liaison.
If I need help but do not know who to ask, I will talk with my UNCW mentor and/or Community
Liaison.
In addition to the above, in my senior year I agree to:
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Research and apply for admission to at least three colleges and/or Universities including UNCW.
I will research and apply for at least five scholarships.
*MI CASA cannot guarantee admission or 100% funding for every student, however we promise to do
everything possible to ensure that every student who completes our program is able to achieve the dream
of a college education.
Mentee name: _________________________
Signature: ____________________________
Date: ______________
Academic and Information Worksheet
Mentee Name: __________________________
High School: _____________________
Mentee email ___________________________
Date: ___________
Post-high schools interests (types of schools, willingness to travel to out-of-state schools,
sports, return to hometown, schools of interest, etc…). Please specify what College or
University is of most interest to you:
Interest Area (Medicine, Law, Teaching, Psychology, Communications, anything):
Nationality:
Parents place of birth:
Hobbies (Sports, art, music, travelling, anything):
List all your recent accomplishments (academic, community or athletic):
Please tell us about any other type of recognitions or extracurricular activities (examples
may include church groups, bands, sports, etc…)
What day (Saturday or Sunday) and time do you think it would be most appropriate to
schedule a parent/guardian meeting?
Comments:
Project MI CASA at UNCW Nomination Essay 2013 - 2014
Student: ___________________________________Date of Birth: _____________________
Social Security Number: _________________ E-mail: ______________________________
Street address: ______________________________________ City:_____________________
State:____ Zip: _______ Home phone: ________________ Cell: ______________________
Eligibility:
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Must be a rising 11th grade Hispanic student in Pender or New Hanover County Schools.
Must have demonstrated on-going commitment to attending a post-secondary school.
Must have satisfactory academic transcripts, discipline records and course selections.
Must be U.S. citizens or legal permanent resident
Student:
Please write a one (1) page essay describing why you would like to participate in Project MI
CASA at UNCW and how you think you will benefit from the experience. Please email essay to
micasa@uncw.edu within 2 weeks of nomination; for questions please call 910-962-2631.