Rights of Passage Independent Living Program Application Process

Transcription

1 Rights of Passage Independent Living Program Application Process We are excited that you have an interest in the Rights of Passage (ROP) program. Attached you will find an application and a recommendation form. The process of applying to ROP is as follows: Recommendation: Before you start to work on your application, give the attached recommendation form to your case manager. If you do not have a case manager, this form should be filled out by an adult involved in the community who knows you well. Application: Complete the attached application, including the personal statement. Once you have finished the application, return both the recommendation and application to ROP. Faxed applications should be sent attention: Jesus F. Siordia Interview: Once we have received your complete application, an interview will be scheduled. This interview will consist of you and two ROP staff. External referrals may also be interviewed by the clinical supervisor. The interview is an opportunity for you to describe your goals and to ask questions about ROP. Evaluation: After the interview, ROP staff will review your application materials and make a team decision. If you have any questions along the way, please do not hesitate to ask one of the ROP supervisors. We can be reached at (323) Ext. 222 or 224. Good Luck. Covenant House California 1325 North Western Avenue Hollywood, CA Tel: Fax: T/ROP/Admission /ROPAPP.doc 1

2 NAME: DATE OF BIRTH SEX DATE: SS# - - PLEASE ANSWER THE FOLLOWING WITH A FEW SENTENCES. 1. What goals have you achieved in your current case plan? 2. The requirements for acceptance into the Rights of Passage program are: (a) a high level motivation to attain goals and successfully transition to independence, (b) ability to behave responsibly in a less structured environment, and (c) the commitment to work and/or attend school at least 30 hours per week. In the space below, please give some examples of how you meet these requirements. Please use real events and accomplishments from your life that are examples of these qualities. a. Highly motivated to attain goals and transition to independence: b. Signs of responsibility to perform in a less structured environment: T/ROP/Admission /ROPAPP.doc 2

3 c. Commitment to work and/or attend school at least 30 hours per week: 3. What are your goals for the future? 4. What are your goals to attain while in the Rights of Passage Program? T/ROP/Admission /ROPAPP.doc 3

4 Personal Statement The purpose of a personal statement is to give you, the applicant, an opportunity to express what participating in Rights of Passage would mean to you. Your personal statement is to be written neatly and legibly in black ink, or typed. Please give personal examples. Use the following outline to write your personal statement: I. Introduction II. Topics (Please respond to A, B, and C) A. Please explain why you should be accepted into the Rights of Passage Program. B. What does commitment mean in terms of commitment to yourself and commitment to the ROP program? C. Next, choose one of the following topics and write about it: 1. What does integrity mean to me? What part does integrity play in participating in ROP? 2. What types of relationships or friendships can I develop in order to grow into the person I want to be? 3. How can experimenting with drugs affect me? affect my living arrangements? affect my friendships? affect my job? III. Conclusion T/ROP/Admission /ROPAPP.doc 4

5 Recommendation Form Name of Youth: Date: Name of Case Manager: Name of Referring Agency (if applicable): Phone Number of Agency and Case Manager: To the Case Manager: Please complete the following recommendation as soon as possible. It is a very important part of the application process. Return the completed recommendation with youth s application to the TLP Director or Residence Manager. Please be as honest and open as possible. Thank you for your time. Please rate the applicant on the following criteria: 1. Applicant is highly motivated. 2. Applicant shows signs of performing well in a less structured environment 3. Applicant has accomplished or will soon accomplish the following (please give a brief explanation following the rating): a. Enrolled in school. b. Enrolled in vocational training. T/ROP/Admission /ROPAPP.doc 5

6 c. Has a job. 4. Applicant is an excellent candidate for Rights of Passage. Please explain any reservations that you might have. 5. Please discuss the applicant s strengths and weaknesses (use the back if necessary). a. Strengths b. Weaknesses Case Manager s Signature Date T/ROP/Admission /ROPAPP.doc 6