Join the Future Inspired Native American Leaders Program!

Transcription

1 Join the Future Inspired Native American Leaders Program! What is it? An exciting program that prepares American Indian high school young men to become college and career ready and learn about their culture! Who is eligible? All American Indian or Alaskan Native male high school students attending high school within Maricopa County. Why should I participate? You will learn about college and career opportunities, how to become successful in your personal life, and build relationships with other young native men and community leaders! What will I do? Develop relationships with other American Indian young men from across Maricopa County. Attend Monthly Saturday Academies to learn about college and career readiness, culture as a strength, and personal development. Participate in additional activities throughout the month related to college, careers, and culture. Receive mentoring and direct access to valuable services for you and your family. Register today! 1. Fill out the attached consent forms. 2. Return packet to the Phoenix Indian Center either by mail, fax, or attachment. Phoenix Indian Center 4520 N Central Ave, Suite 250 Phoenix, AZ Fax: kpolsean@phxindcenter.org Call the Phoenix Indian Center at ext. 2305, kpolsean@phxindcenter.org or visit our website at if you have any questions!

2 Dear Future Participant and Family, The Phoenix Indian Center would like to invite you to participate in an exciting program, Future Inspired Native American Leaders (F.I.N.A.L.), designed for American Indian high school young men in Maricopa County. This program prepares American Indian young men to become college and career ready. We have a strong team creating this program that includes the Phoenix Indian Center, Mesa Public School Native American Program, Phoenix Union High School District Native American Program, Native American Connections and Native Health. We need you to complete the team - you ll have the opportunity to provide input and help build this important program! We offer monthly Saturday Academies and multiple events throughout the month focused on college, careers, and culture. Students will also receive mentoring and support from the Youth Development Specialist at the Phoenix Indian Center. To enroll in this FREE program, please sign and complete the attached form and return it immediately. We look forward to seeing you soon! Thank you, Kalah Polsean Youth Development Specialist Phoenix Indian Center ext kpolsean@phxindcenter.org

3 Saturday Academy Schedule September 13 9:00 AM -1:00 PM Saturday Academy Program Name brainstorming & Final Selection Career Assessment Review & Analyses October 11 8:00 AM 1:00 PM Saturday Academy Volunteerism Native American Recognition Days Parade; Phoenix Indian School Band Building Open House November 15 9:00 AM 1:00 PM Saturday Academy College Readiness and Career Readiness; What will it take to be successful in either opportunity? Designing a Logo! Culture as a Strength; Transitioning to Adulthood - Recognizing Development December 13 9:00 AM 1:00 PM Saturday Academy Winter Celebration and Holiday Luncheon: What makes a great role model?; Learn about archery; play native games and enjoy Winter storytelling. January 10 9:00 AM 1:00 PM Saturday Academy Crafting a powerful Look at Me resume and how to correctly complete an application. Technology in the workplace. Culture as a Strength; Balancing between two worlds February 28 9:00 AM 3:00 PM Youth Leadership Day 2014 Workshops: Tracts Include College Affordability : How to get the best bang for your buck; How to complete a FASFA application; How to research scholarship opportunities and when to apply for them; Positive Habits Build Traditions; Building Soft Skills ; Cultural Resiliency as Prevention; Parent Workshops. March 14 9:00 AM 1:00 PM Saturday Academy Gathering of Native Americans April 11 9:00 AM 1:00 PM Saturday Academy Acing the Interview; interviewing tips Cultural Values as a Strength: Wellness and Health May 9 9:00 AM 1:00 PM Saturday Academy Apprenticeships, Internships and Mentors, Oh My! (Hands On) Cultural Values as a Strength: Wellness and Health June 13 9:00 AM 1:00 PM Saturday Academy Celebration and Can I Afford this? - Financially Fit for Youth checking vs. savings accounts; how to build and a credit score and maintain a good credit score and personal budget; the pitfalls of credit cards Cultural Values as Strength: Wellness and Health Culture is embedded in all Saturday Academies. E.g., Talking Circles, Language and Literature, Rites of Passage, Ceremony, Fatherhood, etc.

4 Future Inspired Native American Leaders Application Checklist Complete the following forms to enroll in the Future Inspired Native American Leaders Program. o Registration Form (Page 5) o Participant Agreement (Page 6) o Phoenix Indian Center Photo / Video / Audio / Written Information Release (Page 7) o Evaluation Permission Form (Page 8) o Demographic Survey (Page 9 &10) o College Interest Survey (Page 11&12) Return packet to the Phoenix Indian Center by mail, fax, attachment, or in-person. Phoenix Indian Center 4520 N Central Ave, Suite 250 Phoenix, AZ Fax: kpolsean@phxindcenter.org

5 Student Information FUTURE INSPIRED NATIVE AMERICAN LEADERS REGISTRATION FORM Student Name: Grade: Gender: School: School District: Phone Number: Home Address: Tribal Affiliation: Parent/Guardian Information Parent/Guardian Name: Phone Number: Transportation Agreement By signing below, I hereby authorize and give full consent to the PHOENIX INDIAN CENTER, INC. to transport my child. Printed Name of Student Printed Name of Parent/Guardian Signature of Student Date Signature of Parent/Guardian Date Participant Release, Indemnity, and Assumption of Risk Statement This Release, Indemnity, and Assumption of Risk statement covers all activities, events, sessions, meals, occurrences, participation, observation, and travel between activities, associated with this project. I hereby give permission for my child to participate. For my child, I agree to assume the risk of any events associated with my child s participation, observation, or other activities that may result in any harm, injury, illness, damage or loss to my child. I hereby release, waive, and hold harmless Phoenix Indian Center, or other organizations involved in the program or any of these organizations agents, personnel or volunteers from any claims, liability, or responsibility for any such injury, illness, damage or loss. I understand the activities are voluntary, and I agree to accept the responsibility for my child s personal safety and participation in the program. I consent to the provision of emergency medical treatment for my child to the extent the treatment is necessary in the medical opinion of the doctor rendering the treatment. If I have any concerns about my child s ability to participate in any event or activity associated with the Phoenix Indian Center, I agree to discuss my concerns with my child s physician before signing this form. Emergency Contact/ Medical Information Hospital/Clinic Preference: Physician s Name: Phone: Allergies/Special Health Considerations: Legal Guardian s Name (Print): Relationship: Signature: Date: Mail, Fax or completed form immediately. Upon receipt of form you will be contacted for the next steps.

6 FUTURE INSPIRED NATIVE AMERICAN LEADERS REGISTRATION FORM CONT. Phoenix Indian Center Staff Responsibilities Explanation of available program activities to eligible participants Assistance with developing goals for eligible participants Education, advisement and assistance to achieve program goals as identified Referral for outside services not provided by program/agency Coordination of services with other agencies related to participant s progress Program Participant Responsibilities Showing up on-time for all schedules activities/events/classes. For any activity with a stipend attached (such as the Career Exploration Summer Session), any time or days missed during the program will result in a decrease in the stipend amount. Notifying staff when you will be late or absent from any scheduled class of activity Informing staff of contact information changes as well as concerns related to the program or activities; e.g. transportation, housing, personal issues, etc. Agreeing to abide by all rules and standards, established by the Phoenix Indian Center Inc. (e.g. no smoking in the building, inappropriate language, improper use of equipment, no drugs, alcohol, and firearms allowed on the premises.) This agreement will remain in effect for the duration of the program. The Program Manager will be advised of any violations of agreement and appropriate action may be taken to remedy the situation, including family discussions or possible suspension from the program. I have read and understand the terms and conditions of this agreement and further understand my responsibilities as a program participant. I understand this authorization shall be in effect for the direction of my acceptance and participation in the program. By signing below, you indicate that you want to participate in this exciting program and that your parent/guardian supports your participation. Printed Name of Student Printed Name of Parent/Guardian Signature of Student Date Signature of Parent/Guardian Date Mail, Fax or completed form immediately. Upon receipt of form you will be contacted for the next steps.

7 PHOENIX INDIAN CENTER, INC. Photo / Video / Audio / Written information Release Future Forward I hereby authorize and give full consent to PHOENIX INDIAN CENTER, INC. to reproduce, publish, display and/or copyright all written information, live broadcasts, still or motion photographs/videos and/or voice recordings taken by them or agents, in which I appear. I release PHOENIX INDIAN CENTER, INC. and its funders, representatives and assignees from any and all claims, demands and causes of action of every nature and kind arising out of or connected with the use of these broadcasts, photographs, videos and/or voice recordings. I further agree that PHOENIX INDIAN CENTER, INC. may use or cause to be used, these items for any and all exhibitions, public display, publications, commercial art and advertising purposes without limitation or reservation or any fee. Student Information Signed: Print Name: Address: Phone: Date: If person signing is a minor, legal guardian must sign below: Parent/Legal Guardian: Date: Print Name: Address: Phone: Mail, Fax or completed form immediately. Upon receipt of form you will be contacted for the next steps.

8 Future Inspired Native American Leaders Evaluation Permission Form Dear Parent/Guardian: As you know, your child is participating in the Phoenix Indian Center s Forward Promise project this year. This is an exciting project designed for American Indian high school boys attending schools within the Phoenix metropolitan area. I am conducting an external evaluation of the project to better understand the program s impact on helping the boys prepare for college and careers.. The project provides a variety of activities for participating youth and their families throughout the year. Here is a summary of the type of information we d like to collect: 1.) Satisfaction feedback on events attended 2.) Student information (grade, age, tribal affiliation, educational aspirations, and school data). 3.) Specific college and career readiness knowledge and skills In addition, we will be conducting group interviews with the students to get a better sense of how well they liked (or not!) the program. I will be conducting the study and am a professional, independent evaluator from Arizona Evaluation and Research Associates. All student data results are confidential, and reports of the study will not include the names or any personally identifying information of any children. Participation in the evaluation is completely voluntary. If your student is interested, we will need your permission to continue. If you are willing to have your child participate in this study, please sign below and return the form by your student. If you have any questions about this project, please feel free to call me at or me at mwhite@azera.org Sincerely, Mary Aleta White, Ph.D. Project Evaluator Student s Name I understand the scope of this project and give my consent for my child to complete the project surveys throughout the year. Parent Signature Parent Printed Name Date * - * - * - * Student s Name I understand the scope of this project and do not give my consent for my child to complete the project surveys throughout the year. Parent Signature Parent Printed Name Date Mail, Fax or completed form immediately. Upon receipt of form you will be contacted for the next steps.

9 Future Inspired Native American Leaders Demographic Survey 1. Student Name: 2. Grade: 3. School: 4. Tribal Affiliation(s): Tribe Enrolled (if enrolled): 5. Age: 6. Who is your primary caregiver? a. Mother b. Father c. Adoptive or Foster Parent d. Grandmother e. Grandfather f. Auntie g. Uncle h. Cousin i. Brother j. Sister k. Self l. Other (describe) 7. What is the highest degree or level of school your primary caregiver has completed? a. No schooling completed b. Nursery school to 8 th grade c. Some high school, no diploma d. High school graduate, diploma or the equivalent (for example: GED) e. Some college credit, no degree f. Trade/technical/vocational training g. Associate degree h. Bachelor s degree i. Master s degree j. Professional degree k. Doctorate degree 8. Please indicate the employment status of your primary caregiver a. Employed for wages b. Self-employed c. Out of work and looking for work d. Out of work but not currently looking for work e. A homemaker f. A student g. Military h. Retired i. Unable to work

10 Future Inspired Native American Leaders Demographic Survey Cont. 9. What is your current household income in U.S. dollars? a. Under $10,000 b. $10,000 - $19,999 c. $20,000 - $29,999 d. $30,000 - $39,999 e. $40,000 - $49,999 f. $50,000 - $74,999 g. $75,000 - $99,999 h. $100,000 - $150,000 i. Over $150,000 j. Would rather not say 10. What is the size of your household? (All people who live with you) a. 1 person b. 2 people c. 3 people d. 4 people e. 5 people f. 6 people g. 7 people h. 8 or more people 11. How many children under 18 years old live in your household? a. None b. 1 c. 2 d. 3 e. 4 or more 12. Does any member of your household receive Food Stamps a. Yes b. No c. Unsure 13. What is the primary language spoken at home? 14. Do you take care of a younger sibling? If yes, how often and normally what times of the day or evening? Mail, Fax or completed form immediately. Upon receipt of form you will be contacted for the next steps.

11 1. Student Name: 2. Grade: 3. School: Future Inspired Native American Leaders College Interest Survey 4. What grades do you usually receive in school? What is your GPA? 5. Where do you access the Internet? 6. Are you aware of course requirements for high school graduation? 7. Check any of the following that apply to you so that we can better help you in this program: o I have missed school several times o I am in foster care or a ward of court o I have a physical disability o I have a learning disability o A member of my household is in jail or prison o I am the first one in my family to go to college o A member of my household is on active duty o A member of my household is unemployed o A member of my household is seriously ill o I am not sure if I will qualify for financial aid o I have responsibilities outside of school (i.e. work) o I have a child o Other (please describe) 8. What are your plans after high school? o Associate s degree (2-year degree) o Bachelor s degree (4-year degree) o Apprenticeship o Certification o Enter the workforce immediately after graduation o Join the military o Other (please describe) 9. Are you aware of admissions requirements at the school you plan to attend? o Check if you have or are planning on doing any of the following: (check all that apply) o Take college prep, AP, or honors level courses o Learn about admissions requirements o File a Free Application for Federal Student Aid (FAFSA) o Complete college applications o Loot at housing options at school you plan to attend. o Visit college campuses to learn more o Take ACT or SAT one or more times o Learn about what types and how much financial aid and scholarships you will need to pay for college o Earn college credits while in high school o Work with a program that can guide you through the college and financial aid application process.

12 Future Inspired Native American Leaders College Interest Survey Cont. 10. I would like more information and support from Phoenix Indian Center about: (Check all that apply) o How to pay for college or other training o Finding about different options for education, training, and careers beyond high school o Which colleges or program to apply to o Identifying who can provide a recommendation o Making sure I am academically ready for college of work o How and when to apply for financial aid & scholarships o Resolving an issue that could prevent you from taking part in education or training beyond high school o How to get ready for college admissions tests o Identifying who can help me through this process o Obtaining fee waivers o How to get a job o Resume writing o Assistance on interviewing o Other (please describe) 11. Please list the schools or program you are considering applying for admissions. 12. List the major areas of study or training programs that interest you. 13. What made you decide on those areas? 14. Do you feel you are academically ready for college-level coursework? 15. If not, what steps do you need to take to prepare for college/major? 16. Have you met or are you planning to meet with you guidance counselor. 17. Do you need any other type of support? If yes, please specify. Remember, this program is here to support you. The more information you provide, allows us to create a program to best meet your needs. Mail, Fax or completed form immediately. Upon receipt of form you will be contacted for the next steps.