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POSI+IVI+Y Mentoring: Mentoring Application 2012-2013


Greetings!

POSI+IVI+Y (positivity) Mentoring is a direct outreach student organization at The George Washington University. We pair one female GW undergraduate with one middle-school girl. We operate through an afterschool program that meets weekly at Francis-Stevens Education Campus (2425 N Street NW, DC).

Our Mission
POSI+IVI+Y (positivity) is committed to the self-development and self-realization of each girl. That each girl finds beauty in herself and everything around her so much that she blooms past her circumstances into success. Through mentoring, workshops, and activities, each girl learns how to achieve her dreams and live a fulfilled life.

Please note that the program meets every Friday from 3:30pm to 5:00pm. All mentors must complete one workshop, fingerprinting, and a TB waiver form before working with the young ladies. Applications are accepted on a rolling basis after 12/29/12. IF there are no spots available, those that qualify are placed on a waiting list in case an opportunity opens up!

Thank you for your interest. We appreciate you and look forward to meeting you!
 
 
 
* First Name : 
* Last Name : 
* Address 1 : 
   Address 2 : 
* City : 
* State : 
* Zip : 
Phone (preferably mobile) : 
* Email Address : 
 
 
 
* What year of school are you in?
 
Freshman
 
Sophomore
 
Junior
 
Senior
 
Graduate student
 
 
 
Major(s) : 
Minor(s) : 
Hobbies/interests : 
 
 
 
* Other Involvement on Campus
   
 
 
 
* Have you worked with 11-14 year olds before?
 
Yes
 
No
 
 
 
* What do you expect to see from POSI+IVI+Y Mentoring?
   
 
 
 
Why do you want to be a mentor? Which qualities do you possess that helps you to be a good mentor?
   
 
 
 
* What do you want to accomplish in life? What do you want people to say about you in 10 years…. 20 years?
   
 
 
 
* Below is a list of 20 personal characteristics arranged in alphabetical order. Add characteristics that are important to you but missing from the list. Check all that apply.
 
Ambitious (hard working, aspiring)
 
Broadminded (open-minded, tolerant, accepting)
 
Capable (competent, effective)
 
Cheerful (lighthearted, joyful, happy)
 
Courageous (brave, standing up for your beliefs)
 
Dependable (reliable, trustworthy, responsible)
 
Forgiving (willing to pardon others)
 
Friendly (pleasant, warm, outgoing, good-natured)
 
Helpful (working for the welfare of others)
 
Honest (sincere, truthful)
 
Imaginative (daring, creative, original)
 
Independent (self-reliant, self-sufficient)
 
Intellectual (intelligent, reflective, knowledgeable)
 
Logical (consistent, rational, realistic)
 
Loving (affectionate, tender)
 
Obedient (dutiful, respectful)
 
Organized (clean, neat, tidy)
 
Polite (courteous, well-mannered, respectful)
 
Self-confident (self-assured, poised, self-aware)
 
Self-controlled (restrained, self-disciplined)
 
Other
 

 
 
 
* Below is a list of 20 values arranged in alphabetical order. Check all values that are important to you.
 
Achievement (attaining personal and professional goals, accomplishment)
 
A comfortable life (a prosperous life, adequate finances)
 
Equality (brotherhood, equal opportunity for all, fairness)
 
An exciting life (a stimulating, active life)
 
Family security (caring for loved ones, being cared for)
 
Freedom (independence, free choice, autonomy)
 
Happiness (contentedness, fulfillment)
 
Inner Harmony (freedom from inner conflict, accord, balance)
 
Leaving a legacy (something that endures after you are gone)
 
Mature love (sexual and spiritual intimacy)
 
National security (protection from attack)
 
Pleasure (an enjoyable, leisurely life)
 
Salvation (deliverance from sin, eternal life)
 
Self-respect (self-esteem, pride, self-worth)
 
A sense of accomplishment (making a lasting contribution)
 
Social recognition (respect, admiration, appreciation)
 
True friendship (close companionship, love)
 
Wisdom (a mature understanding of life, insight, knowledge)
 
A world at peace (freedom from war and conflict)
 
A world of beauty (beauty of nature and the arts)

 
POSI+IVI+Y Mentoring
[email protected] | www. PositivityMentoring.com
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