This is the Eye to Eye Student Coordinator Application for the 2016-2017 Academic Year for the new chapter at CU-Boulder! Please complete this application and email it to
Marrisa Mora by Wednesday March 30, 2016: marrisa.mora@colorado.edu.
A representative from Eye to Eye will follow up with you with next steps.
You may also submit a resume in addition to this application, but it is not required.
Student Coordinators manage the day-to-day operations of the chapter. Key responsibilities include:
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Directing all aspects of the weekly art room, including setup and cleanup, building community, supervising art projects, and managing behavior.
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Recruiting mentors and communicating with them weekly.
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Speaking weekly with an Eye to Eye National Program Coordinator, during a designated phone chat time, about all chapter.
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Working with chapter stakeholders at the Mentee and Mentor schools.
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Organizing activities to build community among the mentors and spread LD/ADHD awareness on campus.
All Student Coordinators are required to attend the Young Leaders Organizing
Institute (OI), which is Eye to Eye’s annual Student Coordinator training. The OI will take place at Brown University in Providence, RI, from August 2 – 7 2016.
Eye to Eye pays for all expenses related to the OI. More information on the OI can be found on our website: http://eyetoeyenational.org/programs/organizing_institute.html
APPLICANT CONTACT INFORMATION
Name: ______________________________________________
Cell Phone Number: ___________________________________
Preferred Email: ______________________________________
Anticipated Graduation (Month and Year): __________________
Anticipated Course of Study: _____________________________
Do you have a (circle or highlight one): Learning Disability ADHD Both
Are you available to attend the OI August 2nd-7th? Yes / No
Anticipated Summer Plans: _____________________________
(If you do not have plans yet, please leave this question blank)
1430 Broadway, Suite 602, New York, NY 10018 t 212.537.4429
w eyetoeyenational.org a mentoring movement for different thinkers

Will you be taking courses on your campus for the entire 2016-2017 school year?
Yes / No
If you answered no, please explain: ________________________
(For example do you plan to study abroad, student teach, or intern?)
OPEN ENDED QUESTIONS
1. Why do you want to be an Eye to Eye Student Coordinator?
2. What skills will you bring to this position? Have you held any leadership positions in the past? If so, what and for how long?
3. What other activities do you anticipate being involved in next year?
4. How would you recruit and maintain a committed group of mentors at your school?
5. Have you ever been arrested or convicted of a crime? If yes, please explain.
1430 Broadway, Suite 602, New York, NY 10018 t 212.537.4429
w eyetoeyenational.org a mentoring movement for different thinkers