Salt Lake Teens Write

Transcription

1 The SLCC Community Writing Center & the Salt Lake City Public Library invite you to participate in an awardwinning mentoring program for local teens. Salt Lake Teens Write (September May 2016) In Salt Lake Teens Write (SLTW), teens are paired with mentors who use writing in their daily lives and professions. Together, they meet to explore how writing opens different pathways to education and successful careers. Any teen entering the 11th Grade this coming fall is eligible to participate in this program. Mentoring teams will meet for 1-2 hours a week and will work together to produce a portfolio of writing based on the teen s interests. They will also attend quarterly writing workshops with the other SLTW mentoring teams. At the end of the year, all of the mentoring teams will come together to collaborate on an anthology publication and public reading to celebrate the different texts they have created during the year. Application deadline for mentors is August 28, For more information on how to get involved with this program, please contact the SLCC Community Writing Center at , cwc@slcc.edu OR

2 Page 1 of 5 Mentor Interest Profile Salt Lake Teens Write Thank you for your interest in serving as a mentor for Salt Lake Teens Write! Mentors will be notified of their acceptance into the program by mid-august. Training will take place at the end of August The program kickoff, where you will meet your mentee, will be in mid-september Please return this Mentor Interest Profile and the Publicity Release to the SLCC Community Writing Center, 210 E. 400 S., Suite 8, Salt Lake City UT, by July 30, Thank you! Date: How did you hear about Salt Lake Teens Write? Were you referred to this program? Yes If you were referred to this program, please list that person s name. Personal Information First Name: Last Name: Street Address: Apt#:_ City: State: Zip: Home Phone (_ ) Cell: ( ) Sex: Female Male Salt Lake Teens Write communicates with mentors primarily by . Please indicate the /s that you use regularly below. Preferred Alternate Criminal Background Check Because you will be working with teens under the age of 18, a criminal background check through Utah s Bureau of Criminal Investigation (BCI) must be completed as part of the application process. There will be no cost to you for the background check; however, we do need your permission before we can initiate this process. Please provide the requested information and initial the appropriate lines below to indicate your willingness to allow us to perform a background check. I give permission for a criminal background check to be performed: Yes Initial: Have you ever been convicted of a felony? Yes Initial: Driver s License #: Date of Birth:

3 Page 2 of 5 Professional Information Company/Organization: Occupation Title: Street Address: Suite #:_ City: State: Zip: How long have you been employed with current employer? Business Phone ( ) Extension: May we contact you at work? Yes Education (please "X" all that apply) HS Diploma Some college AS/AA/AAS degree BA/BS/BFA degree Some graduate school MA/MS/MFA degree PhD/JD/EdD/MD MBA Other education (certificate/diplomas) Ethnic Background (please "X" all that apply) African/African-American/Black Asian Caucasian Pacific Islander Language Use Are you proficient in any language other than English? Yes If yes, indicate which language(s): Arabic/Middle Eastern Native American/American Indian/Alaskan Native Hispanic/Latino/Latina Other Writing Experience What types of writing are you proficient in? (Check all that apply.) Academic Criticism Grantwriting Medical Proofreading Songwriting Business writing Editing Journalism n-fiction Science writing Technical Writing Children s Literature Fiction Marketing/PR Poetry Screenplay/Drama Translation Web-based writing Other, Please list: _ How do you use writing in your daily life and/or profession?

4 Page 3 of 5 Experience Have you volunteered for any other organizations? Yes Do you have any mentoring experience? Yes Do you have any teaching experience? Yes Do you have any business or design skills? Yes (Optional) Please check any areas where you might be interested in donating your expertise: Mentoring Management (helping support our mentor/mentee pairs) Developing Curriculum & Writing Experiments Leading Writing Workshops (Indicate what type): Special Event Planning Publications/ Design Working with Diverse Populations (Please specify): Working with English Language Learners Working with People with Disabilities Working with People Facing Socio-Economic Barriers Other, please describe: Motivation What motivated you to want to join Salt Lake Teens Write? What would you like to accomplish?

5 Page 4 of 5 What qualities do you possess that would make you a good mentor? What are some of the challenges you anticipate with becoming a mentor, and how might you address these challenges? Are you willing to report, on a monthly basis, your experiences and hours spent mentoring? New Ideas Although the Salt Lake Teens Write program will provide extensive training and support to all mentors, you infuse the program with fresh energy and enthusiasm. Please describe what you can imagine creating for the following two situations: A one-hour mentoring session with a 16 year old who is interested in any type of writing. A one-hour writing workshop exercise for a small or large group of teens and their mentors in the genre of your choice. Availability Can you meet the program s minimum standard of spending at least one hour per week with a teen, in addition to attending the quarterly Saturday workshops? Yes Are you willing to travel out of your residential/work neighborhood to meet with a teen? Yes Are you available to participate in Salt Lake Teens Write from September 2015 through June 2016? Yes Do you have any physical accommodation needs you think we should be aware of? Yes

6 Page 5 of 5 References Please provide us with at least one professional reference and one personal reference. These individuals should have known you for at least two years. Please do not use relatives. Professional Reference Full Name (Mr. Ms. Mrs. Dr./Title): Company/Organization: Address: Suite #: City: State Zip Business Phone: ( ) Home Phone: ( ) Relationship to you: Personal Reference Full Name (Mr. Ms. Mrs. Dr./Title): Company/Organization: Address: Suite #: City: State Zip Business Phone: ( ) Home Phone: ( ) Relationship to you: Commitment Statement I,, understand that Salt Lake Teens Write is a voluntary program that I am choosing to participate in. I understand the benefits I will see from being a mentor in this program depend on my willingness and ability to participate fully in the activities (mentoring team, group writing workshops, blog discussions, etc.). I am committed to doing the best that I can to fully participate in all aspects of this writing mentoring program. I certify, by my signature below, that all of the information and statements in this Mentor Interest Profile are true to the best of my knowledge. Signature Date (Typing your name here in an electronic format indicates a legal signature.) Thank you for your interest in Salt Lake Teens Write! If you are selected as a mentor for the program, you will be notified by in August. If you do not have an address, then you will be notified of your acceptance by phone. Mentor training will take place in late August 2015, and the Salt Lake Teens Write program will officially begin in September 2015 at a kick-off celebration where you will be introduced to the teen you will be mentoring.

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