2022-2023 Champions Participation Agreement Date: _____________ Print Student First & Last Name: Print Student Preferred Name: Pronoun(s) Student School Email: Grade: As a mentee, I agree to the following: ☐ Participate in Champions for both semesters of the 2022-2023 school year. ☐ Work with my mentor to discuss my goals and my plan for meeting them ☐ Review my progress and make adjustments as I work towards my goals ☐ Meet with my mentor at least six times during the semester ☐ Work with my mentor to complete progress reports ☐ Student/Champion Signature: As a mentor, I agree to the following: ☐ Provide guidance, encouragement, and oversight as they work towards their identified goals ☐ Review their progress and meet with them a minimum of six times during the semester ☐ Assist with the completion of monthly progress reports ☐ Print Mentor Name: ☐ Mentor Signature: As the Parent or Guardian, I agree to do the following: I, ______________________________________, agree to allow my student to participate in Champions of Wayne for the 2022-2023 school year. I understand that if a Champions of Wayne program administrator determines that my child has achieved their approved goal by the end of each semester, they will receive a $200 reward for their efforts. The $200 reward will be in the form of a check made payable to the student. I further agree to do everything I can to help my child reach their goal. In case of any dispute as to whether my child has achieved their goal, the determination of a program administrator shall be final and binding. Additionally, I give consent for images (photographs or videotapes), sound recordings, and other identifying information of my child to be used by Champions of Wayne. I recognize that these materials may be used in a public way. I also understand that the intended use of such images and identifying information (name, age, graduation year, GPA, etc.) may be used for advertising, marketing, fundraising, and general program publicity. Parent or Guardian Signature: ___________________________________________________________ Champions of Wayne Email: tgccow@gmail.com | Office: Room 249 Use the S.M.A.R.T goal method to set meaningful goals you can achieve! SPECIFIC: To reach your goal, it needs to be specific and well-defined ☐What exactly do you want to accomplish? ☐ Avoid unclear goals, or goals that are too broad MEASURABLE: Identify milestones to track your progress. ☐What and how will you track along the way? ☐How will you know when you’ve achieved your goal? ATTAINABLE: Is the goal realistic or can you reach it by the target date? A good goal should be challenging, but it shouldn’t overwhelm you. Increasing your overall G.P.A from a 2.0 to a 4.0 by the end of the semester is not attainable. However, increasing your G.P.A from a 2.0 to a 2.3 is. ☐Is this goal achievable? ☐Is it possible to meet my goal with effort by the target date? RELEVANT: It the goal worth your time? How will you focus, what will you spend your time on? Realistic is often used in place of Relevant. Can you realistically complete the goal? ☐Is this goal worth my time and effort? ☐Is it a priority? TIME-BOUND: It must have a deadline because goals with deadlines take priority. People tend to lose focus of goals that don’t have deadlines. ☐What is the target date or due date? ☐Are there any checkpoints along the way? S.M.A.R.T GOALS EXAMPLE Here is an example of a S.M.A.R.T. Goal in action! Specific Measurable Attainable Relevant Time-bound What exactly are you going to achieve? My goal is: • I would like to earn at least an A- in my math class How will you measure your progress? How will you know that you met your goal? I will track the progress I make towards by goal by: • Submitting homework on time • Getting at least a B on Exams • Review progress at the end of the each card marking Is it within your power to achieve? My goal is attainable because: • My previous grade was a C+ last semester, because of transportation issues which caused low attendance. I won’t have transportation problems this semester so I will be able to improve my grade. Why is achieving Achieving this goal is important your goal to me because? important to you? • I want to obtain the incentive • I want to graduate with a 3.5 g.p.a • I want to receive credits necessary to move to 10th grade How much time do you have to achieve your goal • The end of the 1st semester • I will complete monthly progress reports to make sure that I’m on track. My goal will be achieved by? earn an A in my Math class and maintain at least a B in all of my other classes Dec 20, 2022 I will ____________________________________________________________________ By ___________, ________________________________________________________________________________________ I will not miss any homework assignments, and get at least a B on all my exams I know I can achieve this goal because __________________________________________________ Check progress monthly ________________________________________________________________________________________ I want to obtain the incentive and complete credits necessary to This goal is important because _______________________________________________________________ I review my monthly progress reports and receive my semester grade I will know I've met my goal when ________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ S.M.A.R.T GOALS WORKSHEET Use the following template to document your S.M.A.R.T Goals! SPECIFIC What exactly are you going to achieve? My goal is: • MEASURABLE How will you measure your progress? How will you know that you met your goal? I will track the progress I make towards by goal by: • ATTAINABLE Is it within your power to achieve? My goal is attainable because: • RELEVANT Why is achieving your goal important to you? Achieving this goal is important to me because? • TIME-BOUND How much time do you have to achieve your goal My goal will be achieved by? • By ___________, I will ____________________________________________________________________ ________________________________________________________________________________________ I know I can achieve this goal because __________________________________________________ ________________________________________________________________________________________ This goal is important because _______________________________________________________________ I will know I've met my goal when ________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ S.M.A.R.T GOALS (EXAMPLES) The goals listed below are two vague. Look at how they have been transformed into a S.M.A.R.T. Goal: I want to be a better student Specific Measurable Achievable Relevant Time-based I want to improve my overall GPA from 2.8 to 3.0. I will pass all of my classes with at least a B+ or better. I will meet with a tutor every week to help me focus on my weak areas. I'd like to earn the Champions Incentive I still have six weeks until midterms. This leaves me plenty of time to meet with my teacher and decide if I need to take any additional steps. Goal: I want to get good grades Specific Measurable Achievable Relevant Time-based I want to get an A- in Math I will earn at least A- on all my final exams I received a B+ last semester, even though I had 6 missing assignments. If I complete all my assignments and receive high scores on them, I should be able to meet my goal I'd like to be able to receive scholarships for college. I still have 8 weeks until midterms.
