Application Form

advertisement
Peer2Peer
Program Information
Peer2Peer is a program open to 8th grade students who demonstrate the ability to be positive
role models to their peers. There are approximately ten (10) spots in the program, and every effort
will be made to accommodate a variety of students to create a well-rounded and diverse group.
All Peer Leaders will receive training to help prepare them for their role as leaders. A Peer
Leadership Workshop has been arranged for the 2013-2014 Peer Leaders. This will take place on
Wednesday, October 9th, 2013 and will cover the following topics: leadership styles, goal-setting,
trust, communication, and problem-solving. At several points in the program, group discussions will
be conducted to reinforce learning.
Some Peer Leader responsibilities include: active participation in weekly meetings, various
outreach activities, and school-wide initiatives. Whenever possible, meetings will be held during
lunch and/or activity period so that no instructional time is missed. Prior to outreaches and schoolwide activities, however, Peer Leaders may be asked to attend meetings before, after school, or
during class time. Should this situation arise, Peer Leaders understand that it is their responsibility to
make up any missed work.
I am thrilled to be the Peer2Peer coordinator again this year, and I look forward to working
with our 2013-2014 leaders. This is an important role with the potential to positively influence
classmates and the community. All leadership roles and responsibilities should be taken seriously so
that the program is as successful this year as it has been in the past.
Thank you for your interest in Peer2Peer and good luck!
-Dr. Bradley
School Counselor
1
Peer2Peer
Application Form
DEADLINE: Friday, September 13th, 2013
Please type or write neatly! Attach additional sheets as needed.
Name: ____________________
Grade: _____
Please answer the following questions:
1. What three (3) words would you use to describe your personality?
_______________________
_______________________
_______________________
2. Do you have any leadership experience (i.e. clubs, community service, jobs, hobbies, etc.)?
Yes_____
No_____
If so, what was your role and responsibility in each activity?
3. Peer Leaders serve as positive role models for their peers. What does that mean to you and how
would you act as a positive role model?
4. Describe what you will contribute to Peer2Peer. What qualities, skills, and interests do you have
that will make you a valuable member of the group?
5. Explain why you want to be a Peer Leader and what you hope to learn from participating.
2
Peer2Peer
Peer Pledge & Permission
DEADLINE: Friday, September 13th, 2013
PEER PLEDGE
If I am selected as a Peer Leader, I will actively participate in all training classes, meetings, and
outreach activities. I will be aware of my influence as a role model and I will behave accordingly.
Specifically, I will uphold all school rules and respect the law both in and out of school.
_____________________________
Student Signature
_______________
Date
PARENT/GUARDIAN PERMISSION
My child ___________________________ has permission to participate in Peer2Peer for the 20132014 school year, should he/she be selected. I will support my child’s involvement in Peer2Peer
and understand his/her responsibility to serve as a positive role model.
_____________________________
Parent/Guardian Signature
_______________
Date
PEER LEADER TRAINING WORKSHOP PERMISSION
My child ___________________________ has permission to participate in the Peer2Peer
Leadership Workshop on October 9thth, 2013. I understand that I will need to provide
transportation for my child after the workshop as there is an early dismissal from school that day.
_____________________________
Parent/Guardian Signature
3
_______________
Date
Download