Please complete and return ALL sections of the application to the Child and Youth Program Office. All applications are due by October 1, 2018.

Similar documents
arts education scholarship fund application

MISSOURI STATE HIGHWAY PATROL YOUTH ACADEMY PROGRAM June 11 - June 17, 2017 Sunnyhill Adventures - Dittmer, Missouri

JETER S LEADERS APPLICATION

Delta Kappa Gamma Society Scholarship

YMCA OF GREATER NEW YORK SUMMER DAY CAMP REGISTRATION FORM

LETTER TO THE STUDENT SCHOLARSHIP APPLICANT

US Air Force Youth Programs AFTC Representative and Adult Advisor Application

KIDZKONNECT Calgary Zoo/TELUS Spark Youth Volunteer Program KidzKonnect Leader Opportunity Description and Application

Dear Parent/Guardian,

Kauai Community Federal Credit Union Scholarship Program

APPLICATIONS MUST BE POSTMARKED BY MAY 31, Delta Sigma Theta Sorority, Inc. Montgomery (AL) Alumnae Chapter

Indiana Military Teen Council Application Packet

Pearls of Vision Foundation, Inc.

Student Admission Application Form

2017 Jumpstart MS Scholarship Application

HOSTEL REGISTRATION

Cook Apprentice Exploratory Program: SAIT

Kansas City Associated Equipment Distributors Scholarship Application

Palmetto Health Tuomey Student Volunteer Application Application to be completed by the student, NOT the parent. Full Name: Phone: (

Youth in Philanthropy STUDENT APPLICATION

Molokai Chamber of Commerce Business Scholarship 2017 Scholarship Application

Rotary District 5180/5190 RYLA REGISTRATION FORM 2018

2018 Super Summer Student Registration Form

Pathfinders-Su eala Mo Samoa High School Scholarship Packet

2018 East Texas Rural Electric Youth Seminar

WHAT IS CAMP ENTERPRISE?

University of North Texas UNTWISE Attention: Live and Learn Summer Program 1155 Union Circle # Denton, Texas

SCHOLARSHIP APPLICATION

2018 Combined Scholarship Fund (CSF) Application

Watermarks MS/HS Camp Information

CUMBERLAND COUNTY FARM BUREAU FOUNDATION 2018 SCHOLARSHIP PROGRAM

Fall Youth Soccer League

National Association of Educational Office Professionals 1841 S. Eisenhower Ct. Wichita KS 67209

Michael Jordan. Questions? Please contact: Director of Youth Ministry. Phone: x230

Kansas City Associated Equipment Distributors Scholarship Application 2017

4-H HEALTHY LIVING RETREAT OCTOBER 13 TH -15 TH. Learn about careers & other opportunities in the healthy living field!

Zionsville Athletic Booster Club Scholarship Application

Rotary Club of Navarre 2017 Scholarship Application Form

Kairos Retreat for Teens [SFK13] September 22, 23, 24 & 25 th, 2016

North Carolina 4-H Application for State 4-H Office

HIGH SCHOOL YOUTH TRIPS 2018 APPLICATION

CRANFORD POLICE DEPARTMENT YOUTH POLICE ACADEMY

State Officer Application - SLC 2016

Applications are due (received by) March 1st, 2018!

CTS Application Guidelines

APPLICATION DEADLINE MARCH 31 ST

SAN ANTONIO DE PADUA CHURCH YOUTH MINISTRY REGISTRATION FORM

APPLICATION

Select the scholarship in which you are applying for. Sagebrush Circuit Lew and Jo Eklund Scholarship. Applicant Name ApHC/AYA Number ApHC Territory

Mesa Lodge No. 55, A. F. & A. M. P.O. Box 4794 Grand Junction, CO 81502

Georgia Pilot Foundation, Inc 2018 Anchor Scholarship Application

General Information & Preparation

Certified Volunteer Long Term Care Ombudsman (VOP) Application

Appaloosa Youth Foundation

Rotary Club of Navarre 2018 Scholarship Application Form

Disney Band Trip 2017

MESA Summer Academy: Solar System Mission Possible Application Deadline: June 1, 2018 Early Bird Discount Deadline: May 1, 2018

1. Ensure you answer each and every question on your application. 3. Letter of Acceptance from the institution you will attend.

ST. TAMMANY CANCER FUND COLLEGE SCHOLARSHIP PROGRAM 2018 Academic Year

State 4-H Ambassador Application

Athens Mayor s Youth Commission New Applicant

MERRIMACK COUNTY FARM BUREAU 295 Sheep Davis Road Concord, NH 03301

Mauldin Police Youth Academy Enrollment Application

2013 NATIONAL LAW ENFORCEMENT EXPLORING LEADERSHIP ACADEMIES FACT SHEET

RETURNING STUDENT INFORMATION UPDATE

2018 MARSHALL COUNTY LAW ENFORCEMENT YOUTH CAMP APPLICATION

Recreation Council of Greater St. Louis Recreation Voucher Program for St. Charles County Overview of the Program

2017 Fall Field Hockey Co-ed, Grades 1-8

THE RANCH SUMMER CAMPS 2018 Counselor-In-Training Program FIRST-YEAR ANGEL ISLAND CIT

Shane M. Montgomery 11 ~ Memorial Scholarship Fund

Youth Leadership Rolesville Application

Scheduling Permission Form

Association of Texas Leaders for Education Scholarship

2018 YOUTH MEMBER DEVELOPMENT

Deadline for application: April 1-29, Dear Summer Teen Applicant:

Summer Day Camp Registration 2018 Pierce County School Based Day Camps YMCA OF PIERCE AND KITSAP COUNTIES

ASHBURN-STERLING LODGE No. 288

NATIONAL THIRD VICE COMMANDER PROGRAM. THOMAS J. CUITE SCHOLARSHIP FOUNDATION RULES (Eligibility - High School Seniors)

YOU! SPLASHWAY WANTS. JoinSplashway.com We are family. SUBMIT YOUR APPLICATION NOW. DEADLINE IS WEDNESDAY, MARCH 9 TH.

Huntington University Nursing Career Academy Application Process Summer 2015

Dear Prospective TeenAge Volunteer,

Alpharetta Recreation and Parks Department 2018 Wills Park Summer Day Camp Counselor In Training Handbook

PASADENA YMCA 2014 Winter Basketball Registration Form

Application for 2016 Penn State College of Communications Summer Camp

Chico State Intelligent Systems Lab Summer Robotics Camp General Information

College Scholarship Application Deadline: January 31, 2015

Science- Sational Day!

Camp Hero Registration 2017

Paramedic Application. Our Mission. The Application Process

Illinois Farm Bureau & Affiliates 4-H PREMIER LCP AWARD

Student Application

Metropolitan Kappa Youth Foundation. Lawrence Hamm, Sr Scholarship Packet

2017 NOSC SCHOLARSHIP APPLICATION A High School Senior

Superintendent s Regulation 4400-R Exhibit 1

Kerry Dyte Educational Scholarship

United States Arctic Youth Ambassadors

ST. TAMMANY CANCER FUND COLLEGE MEMORIAL SCHOLARSHIP PROGRAM 2018 Academic Year

August 19-24, 2014 (Tuesday-Sunday)

Implementation Guide School Support Programs for Military Youth and Teens

PROSPECT PARK ZOO Project TRUE Urban Ecology Program Application School Year (Please Print)

Transcription:

State Teen Panel (STP) 2018-19 Application Due to: Mark Lukasiewicz Office Phone: 515-252-4050 Fax: 515-727-3103 Email: mark.s.lukasiewicz.ctr@mail.mil Child & Youth Program Coordinator Address: JFHQ A-1 RM 186 7105 NW 70th Avenue Johnston, IA 50131 Requirements for Eligibility Applicant must be between the ages of 13 and 17 as of September 1, 2018. Applicant must be a Military connected youth (a dependent, sibling, and/or stepchild) of an Army or Air Force National Guard Soldier). Applicant must be able to commit to the objective, key results, and schedule listed in the position overview document during the 2018-2019 year (fall, spring, and summer). Please complete and return ALL sections of the application to the Child and Youth Program Office. All applications are due by October 1, 2018. SECTION I: Applicant Information Full Name: Preferred Name: Date of Birth: Age: Gender: M F T-Shirt Size: Youth L Youth XL Adult S Adult M Adult L Adult XL Mailing Address: Facebook ID: Cell Number: Email Address: SECTION II: Parent/Legal Guardian Information Name of Mother (or primary legal guarding): Occupation: Cell Phone: Work Phone: Email Address: Name of Father (or secondary legal guarding if applicable): Occupation: Cell Phone: Work Phone: Email Address: STP Application - 1 -

SECTION III: School Information Year in School (Fall 2018): 7 th 8 th 9 th 10 th 11 th 12 th Name of School: Address of School: School Office Phone: SECTION IV: STP Please complete the following six questions on a separate document and attach to the final application. Acceptance will be based on the quality of answers provided by the applicant and the applicant s eagerness in involvement with the State Teen Panel. 1) Tell us about your life experience as a military connected youth. 2) Give an example of someone you look up to as a leader and why they take that place in your life? 3) The Child & Youth Program is available to any teen with a family member in the Military throughout the entire state. If you could dream about the impact of this program, what comes to your mind? 4) As a member of the STP, you will serve as a role model for others in our state. What qualities do you believe a role model should possess and in what ways do you personally demonstrate some of those qualities? 5) There are many short speaking opportunities for STP members. What experience(s) do you have speaking in public? 6) How much experience have you had with time management? What are other extracurricular activities you will be involved in during the fall, spring, and summer months? How will you keep the STP a priority in a busy schedule? SECTION V: Letters of Recommendation Please submit both letters with your application. These letters should include an email address and/or phone number for the person writing the letter. 2 Letters of Recommendation Required 1. One from a relative or family member. 2. One from a person not related to you. (Examples include but are not limited to a teacher, coach, or community leader such as a Boy/Girl Scouts Leader, 4-H Leader, Pastor, or other Youth Leader.) STP Application - 2 -

SECTION VI: Required Signatures Parent/Guardian Permission and Release I will support my child as he/she serves the Youth Program if they are selected as a delegate of the State Teen Panel. I am willing to allow my child to travel or provide transportation myself to help them fulfill all responsibilities of this position. In addition, I hold the Iowa Youth Program, its Contractors, the Services Branch Office, the National Guard Bureau, the National Guard Child and Youth Program, program volunteers and the harmless from injury or death that occur as a result of participation. Parent/Guardian Signature Date Youth Participant Pledge As a military connected youth myself, I believe in the importance and impact of the Child and Youth Program and pledge to support and serve its core values with my best efforts through the State Teen Panel. I pledge to assist the Child & Youth Program Coordinators with the mission and vision of the Youth Program, to own the objective of the Teen Panel, to strengthen my personal leadership skills as an active member of the Teen Panel, and to be an advocate for all military connected youth in the state of Iowa. I am aware that, should I be selected as a delegate of the STP, it is my responsible to ensure that safe transportation is available for me to attend the required meetings (see Schedule section in Position Overview Document). I understand that failure to attend meetings may result in their dismissal from the STP. Youth Applicant Signature Date *Please Note Acceptance and service on the Iowa State Teen Panel is done strictly in a statutory volunteer status. There will be no payment for hours worked; however, associated travel costs will be reimbursed to the selected applicant and volunteer hours will be recorded for events attended as part of the STP. STP Application - 3 -

State Teen Panel (STP) Position Overview Child and Youth Program VISION & MISSION Vision: We exist to impact the culture of Military connected youth in Iowa so that they and their families thrive in the face of challenges. Mission: We provide a support system to Military youth and their families through programming events, teaching life skills, managing resources, and connecting to local communities. Child and Youth Program CORE VALUES We behave with the following three core values toward military families and the sacrifice they make for our nation. 1. You re not just guests you re family. Hospitality We make it as easy as possible for families to feel welcomed and connected to the National Guard Family. 2. We hear your cries and we want to help. Empathy We seek to understand and positively impact the very real challenges military connected youth face. 3. We understand that freedom comes with a price. Compassionate support and honor We are proud of all Military families and will always go the extra mile to serve them. ROLE OBJECTIVE The STP exists to help the LCYPC and CYPC fulfill the Child and Youth Program mission and vision by assisting in event planning and execution, strengthening their personal leadership skills, and ultimately being a voice for Iowa s Military connected youth. KEY RESULTS The STP position is held for one year. The member can then choose to reapply for additional years after. During the year they are expected to: Be an advocate for key challenges that Military connected youth currently face. Develop leadership, teamwork, and networking skills. Take part in selected events sponsored by the CYP. Participate in all meetings and retreats. Be eager to represent the STP and/or the CYP at community events if the opportunity arises. Be actively pursuing public service in and around your community.

SCHEDULE Fall Forum This event will be an overnight stay in November at a hotel in the Des Moines area. It will include training and activities to help STP members connect and plan for the year, resilience and life skill teaching and a service project. Spring Retreat This event will be a full weekend in February and will take place on Camp Dodge. It will include leadership workshops led by an internationally renowned trainer BJ Penick, Military-based team leadership training, Month of the Military child planning and preparation, and many opportunities to connect. Summer Regional Conference Every year the STPs from Region 7 (Iowa, Missouri, Kansas, and Illinois) gather for a four day conference in June. The location rotates between states. The goal of this event is to foster connection and ideas across the different state s teen panels. This is the number one event for the teen panels throughout the year. Program guidelines allow 10 members to participate when Iowa hosts the conference and 5 members to participate when it is out-of-state. Plan and participate in selected CYP events. Each semester (fall, spring, and summer) we will present 1-3 events that the STP will have opportunities to help plan and execute. We require participation in at least one of these events each semester and will work to keep the events within a 2 hour driving radius of the member s home location. Community Service Each STP member must record a total of 10 hours of community service between November 2018 and August 2019. A volunteer Record Sheet will be provided to record these voluntary contributions and will be collected at the end of August. ELEGIBILITY/REQUIREMENTS Must be between the ages of 13 and 17 as of September 1, 2018. Must be a Military connected youth (a dependent, sibling, and/or stepchild) of an Army or Air Force National Guard Soldier). Must be able to commit to the above objective, key results, and schedule during the 2018-2019 year (fall, spring, and summer). Must complete the application in order to have an opportunity to be selected. Contact Mark Lukasiewicz, Child & Youth Program Coordinator, at mark.s.lukasiewicz.ctr@mail.mil for additional questions. You can find the link for the 2018 STP Application on the Youth Page at www.iowacyp.com. All applications are due October 1, 2018.