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Creative Writing Mentors Needed for Young Writers Ages 9-19!
Mentor Stipend $300
Attention Writers!! Wings is a program designed for avid young writers desiring more support and guidance than is provided in the traditional school setting, or even in the average creative writing class. Wings pairs you with a young writer (ages 9-19) for a mentorship that will run from May through August 2008 As a Wings mentor, you are expected to help young writers explore their worlds, imaginations, and writing skills through guided reading, writing, and conversation. Reading suggestions and writing exercises will be provided, but the best mentors teach what they know and love. Mentors are encouraged to bring their own writing and the writing of authors that they admire to the table. Mentors are paid a stipend of $300. 2008 Program Schedule May 3: Program Kickoff! May 5-June 1: Mentors meet with youth for total of 8-hrs (2-hrs per week suggested) June 2-August 11: Mentors meet with youth for total of 10-hrs (2-hrs every other week suggested) August 18: Young Writers Read! (public reading at Intermedia Arts)
DEADLINE EXTENDED! Apply by Wednesday, April 16, 2008
HOW TO APPLY: 1) Complete the attached application form and supplementary documents • Cover Page • Personal Statement • Authority to Release • Confidentiality Policy • Publication Consent • Questionnaire • Resume and/or CV—include relevant teaching experience, education, and publication creadits 2) Submit application materials to: Intermedia Arts Attn: WINGS 2822 Lyndale Ave S, Minneapolis MN 55408 or info@intermediaarts.org Questions? Call 612.871.4444.
SASE Wings Mentor Application: Cover Page
Name: ________________________________________________________________ Address: ______________________________________________________________ City, State, Zip: _________________________________________________________ Home phone: ________________________ Cell Phone: ________________________
Email: _________________________________________________________________ Please answer the following questions fully. It may be necessary to answer some questions on a separate sheet. 1) To determine whether this program is a good fit for you, please check the following that apply: __ I enjoy working with young people and am excited to share the craft of writing __ I will be available to meet with and mentor a young writer for a total of 18 hours from May through August 2008 2) Which writing genres are you comfortable teaching? Most young writers will not have decided on a genre and will need to experiment with more than one, so please check all that apply. This will help us pair you with a compatible young writer: __ Short Fiction—please specify: (Mystery, Fantasy, etc.) __ Long Fiction (novel/novella length)—please specify: (Mystery, Fantasy, etc.) __ Poetry __ Creative Non-Fiction / Memoir __ Spoken Word
3) Will you be applying for independent study credit in relation to this mentorship experience? 4) Have you had any experience teaching creative writing classes or workshops? Please explain briefly. 5) Why would you like to be a Wings mentor?
PERSONAL STATEMENT
**Please write a statement introducing yourself to your mentee—tell them about yourself, your writing, your literary interests/background etc:
Authority to Release Information
I understand that in processing my application with Intermedia Arts, an investigation may be conducted to obtain and verify information relating to my past activities and background. Information may include, but is not limited to: employment history, education, criminal records, credit history, motor vehicle records, personal references, and any data provided on this application, or during the interview process. If currently employed: My current employer may be contacted ____ YES ____ NO I authorize the appropriate individuals, companies, institutions, or agencies to release information and I release them from any liability as a result of such inquiries or disclosures. I understand that in processing my application with Intermedia Arts, periodic background checks may be made at any time during my relationship with Intermedia Arts. I further understand and waive my right of privacy in this investigation and release and hold harmless Intermedia Arts and its agent, Verified Credentials, Inc., from any liability. An investigative consumer report may be generated summarizing this information. I have a right under the “Fair Credit Reporting Act” to obtain a copy of this report by providing proper identification and directing a written request to Verified Credentials Incorporated, 20890 Kenbridge Court, Lakeville, MN 55044. 1-800-473-4934. I may also obtain a copy of this report by checking the “YES” box below. I would like a copy of any report regarding me. ____YES ____NO
I agree that any decision to accept me and/or retain me as a volunteer is contingent upon the results of my background investigation, and certify that all statements and answers on my application or interview are true and complete to the best of my knowledge. I understand that if any statements and/or answers are found false or the information has been omitted, such false statements or omissions may be cause for rejection or termination of my employment or application. If accepted as a Wings Mentor for Intermedia Arts, I will maintain the statutorily required amount of auto liability insurance coverage during the duration of my match and provide proof of that coverage to Intermedia Arts.
(cont’d on next page)
Authority to Release Information (cont’d)
LAST NAME
FIRST NAME
MIDDLE NAME
PREVIOUS NAME/MAIDEN NAME/A.K.A, INCLUDING DATES CHANGED
STREET ADDRESS
CITY
STATE
ZIP CODE
PLEASE LIST THE CITIES, STATES, COUNTRIES AND ZIP CODES YOU HAVE LIVED IN, IF THE ABOVE ADDRESS DOES NOT ENCOMPASS 7 YEARS
SOCIAL SECURITY NUMBER
DATE OF BIRTH
DRIVERS LICENSE NUMBER
STATE ISSUED
I UNDERSTAND THAT A PHOTOCOPY OF THIS AUTHORIZATION WOULD BE ACCEPTED WITH THE SAME AUTHORITY AS THE ORIGINAL
SIGNATURE
DATE
Confidentiality Policy
It is the policy of Intermedia Arts to honor the privacy of our children, their families, and volunteers. The agency will only share confidential data in a manner consistent with the professional and legal responsibilities of the agency. All records are considered the property of the agency and not agency employees; children, their families; or volunteers. In order to provide a service that is in the best interest of the children served by the program, information from outside sources, including confidential references must be assessed along with information gained from the children and or volunteers. Limits of confidentiality 1. As part of the matching process summary information will be shared with the appropriate participants. In turn, information discussed with me regarding a potential match will be respected and kept confidential. 2. For purposes of program evaluation or audit the agency will allow access to agency records to those persons deemed appropriate by the agency. 3. If presented a valid subpoena the agency will provide information to law enforcement officials. 4. In the event of litigation or potential litigations the agency will provide information to its legal counsel. 5. In accordance with the state mandated reporting act, the agency will provide confidential files to appropriate officials. I have read and understand, or have had explained to me and understand the agency policy with respect to confidentiality of child and volunteer records. I agree to program participation under the conditions set forth. ________________________________ ______________________________ Parent/Guardian/Volunteer Name Child Name
________________________________ ______________________________ Parent/Guardian/Volunteer Signature Date
Publication Consent
Identifying information regarding children and mentors may be used in agency publications or promotional materials. Intermedia Arts has the right to use all audiotapes, slides, photographs, film, video, or any other pictorial representation of children and volunteers as deemed appropriate by the agency. Intermedia Arts also has the right to exhibit, sell or transfer to any person or organization which the agency deems appropriate any such slides, photographs, films, video or audio tapes. I herby give my permission for Intermedia Arts to use now and in the future the abovementioned information/photographs. __________YES __________NO
I understand that this information may be used for agency publications or promotional materials. In giving consent, I release Intermedia Arts from any obligation or liability otherwise owed to me in connection with the above referenced identifying information. This consent will expire upon my giving written notification to Intermedia Arts. ________________________________ ______________________________ Parent/Guardian/Mentor Name Child Name
________________________________ ______________________________ Parent/Guardian/Mentor Signature Date
Applicant Questionnaire
EXPERIENCE WITH YOUTH AND MATCH CONSIDERATIONS: Describe your experience(s) with children/youth:
Based on your experience(s) what do you feel is important for us to consider in matching you: (age, race/ethnicity, personality, behaviors, comprehension level)
DRIVING RECORD/ CRIMINAL HISTORY: Have you ever been accused or arrested of a crime? (If so, please explain)
Have you ever been charged or convicted or sexual abuse of a child? (If so, please explain)