Peer Leader Workshop Application

Introduction
In order to attend the PeerForward Summer Workshop, you and your student must complete and sign these Permission Forms. Instructions for completing the Permission Forms are included in each section. Please assist your son/daughter with completing the PeerForward Program Permission Forms. These forms are to be completed online. 

If you need an application in Spanish or Haitian/Creole, you can request a paper application from your PeerForward Coach

Congratulations! Your student has been chosen to become a PeerForward Peer Leader! Out of hundreds of thousands of students nationwide, only a select few are given this unique opportunity to set a path for their college and career futures – and learn how to motivate their peers to do the same. We believe that your child has the power to influence their peers, and reach their own college and career goals.

 

With the launch of PeerForward, our campaign for the next generation, PeerForward will connect 1.8 million students to college and career over the next decade. And we want your child to be a part of this movement.

 

Your student will be part of an 8-person PeerForward team, who will train, coach, and empower their peers to achieve three benchmarks associated with increases in college enrollment in even America’s most under served high schools:

  1. Complete three or more college applications
  2. Early filing for scholarships/Free Application for Federal Student Aid (FAFSA)
  3. Creating campaigns to address a concern or issue in their community to effect change.

Over the last two decades, we have ignited the power of peer influence in more than 600 high schools. Our schools are leaders in the movement for student-driven positive change.

 

Your student will have the opportunity to attend a hybrid virtual and in-person PeerForward Workshops. During the PeerForward Workshop your student will:

  • Receive personal and professional development from PeerForward Coaches and Volunteers

  • Develop specialized plans and strategies for campaign activities, events, and data collection within their school
  • Collaborate with other local PeerForward Teams to increase college enrollment rates across an entire community
  • Learn the principles of youth activation to set goals in tandem 

For seniors only, your student will also:         

  • Learn the methodology of writing a compelling personal statement to stand out from thousands of high school graduates applying to the same colleges, the same scholarships, and even the same jobs.
  • Meet one-on-one with a professional college coach to think about next steps in the application process and build a list of colleges to consider.

In order to attend the PeerForward Summer Workshop, you and your student must complete and sign these Permission Forms. Instructions for completing the Permission Forms are included in each section. Please assist your son/daughter with completing the PeerForward Program Permission Forms. These forms are to be completed online.

 

Before submitting an application, please review our privacy policy here:

https://www.peerforward.org/wp-content/uploads/2020/08/Privacy-Policyupdated.pdf


If you have any questions concerning this program, please contact your school’s PeerForward Advisor. We look forward to working with you and your child in the upcoming months.


Sincerely,

 

PeerForward

Permission to Participate in a PeerForward Workshop and Release of Liability

This document gives your student permission to attend PeerForward's Training Camps and/or Workshops.

Parent Liability Release

PLEASE READ CAREFULLY. THIS DOCUMENT AFFECTS YOUR LEGAL RIGHTS AND IS LEGALLY BINDING. BY SIGNING THIS AGREEMENT, YOU ARE RELEASING PEERFORWARD FROM ALL LIABILITY AND FOREVER GIVING UP ANY CLAIMS THEREFOR

 

Assumption of Risk

 

I, in my legal capacity as parent/guardian of the minor named below (“Minor”), acknowledge and agree that any use of PeerForward facilities, services, equipment and premises (“Facilities”) and any participation in PeerForward programs and activities (“Programs”) comes with inherent risks including, but in no way limited to: (1) moderate and severe personal injury, (2) property damage, (3) disability, (4) death, and (5) sickness or disease including, without limitation, COVID-19. I voluntarily, for myself and Minor, accept and assume full responsibility for these risks as well as any and all other risks of the use of Facilities and participation in Programs. I agree that I have full knowledge of the nature and extent of all such risks and am not relying on all such risks being described in this document.

 

Waiver, Release, Indemnification & Covenant Not to Sue

 

In consideration of Minor’s use of Facilities and participation in Programs I, in my legal capacity as parent/guardian of Minor, agree on behalf of myself and Minor that PeerForward, its officers, directors, agents, employees, volunteers, insurers and representatives (“Releasees”) will not be liable for any personal injury, property damage, disability, death, sickness or disease incurred by Minor, however occurring including, but not limited to, the negligence of Releasees. I understand that Minor and I will be solely responsible for any loss or damage, including personal injury, property damage, disability, death, sickness or disease sustained from the use of Facilities and participation in Programs.

 

I further agree, in my legal capacity as the parent/guardian of Minor, on behalf of Minor, myself, and any and all legal successors and proxies, to release and HEREBY DO RELEASE, WAIVE AND COVENANT NOT TO SUE Releasees from any causes of action, claims, suits, liabilities or demands of any nature whatsoever including, but in no way limited to, claims of negligence, which Minor, myself, and any and all legal successors and proxies may have, now or in the future, against Releasees on account of personal injury, property damage, disability, death, sickness, disease or accident of any kind, arising out of or in any way related to the use of Facilities or participation in Programs, whether that participation is supervised or unsupervised, however the injury or damage occurs, including, but not limited to, the negligence of Releasees.

 

In further consideration of the use of Facilities and participation in Programs, I, in my legal capacity as parent/guardian of Minor, agree on behalf of myself and Minor to INDEMNIFY AND HOLD HARMLESS Releasees from any and all causes of action, claims, demands, losses, suits, liabilities or costs of any nature whatsoever, including claims of negligence, arising out of or in any way related to the use of Facilities and participation in Programs.

Permission to Participate in a PeerForward Workshop and Release of Liability

Transcript, Photo, and Review Portfolio Release

I understand that my student’s school transcripts are used by PeerForward for student counseling sessions and for statistical analysis.  I understand that PeerForward strictly protects the confidentiality of student transcripts.  I hereby authorize the release to PeerForward of my students's school transcripts.

 

I also consent to the use of my student’s name, likeness, essay, and speech, whether written or spoken, in any audiotape, videotape, film, book, or photograph made at the Workshop, Training Camp, or any PeerForward program or event for any informational, instructional, and/or fundraising purposes of PeerForward, including the use of such media via dissemination through PeerForward’s websites and social media platforms.


I also give PeerForward permission to video record sessions in order to ensure the safety of all participants, quality of interaction and evaluate coaching techniques. The video file(s) will be treated with confidentiality and will only be accessed by PeerForward staff. 

 

I also give PeerForward permission to provide my and/or my student’s contact information and other personally identifiable information to colleges, universities, and other educational institutions with which PeerForward partners toward its mission, in order to help such colleges, universities, and other educational institutions identify and contact students with information about educational opportunities.

 

I also give PeerForward permission periodically to trace and record my student’s postsecondary status, including, but not limited to, my student’s postsecondary enrollment and graduation status.  I permit PeerForward to track and record my student’s postsecondary status with or without the child’s prior consent.  I permit PeerForward to use any and all previously-released or -provided personal information regarding my student, and/or to provide such information to the National Student Clearinghouse or an affiliated or similar service, in connection with PeerForward’s postsecondary status tracking efforts.

 

Peer Leader Code of Conduct


General Information

Student Info

Please ensure your address is accurate and completed in full.



Enter a mobile phone number that you will have access to.
Enter your personal email address NOT your school given email

Please use your personal email, NOT your school provided email.









Financial Verification



Demographics




Medical Information 

THE FOLLOWING questions are MEDICAL-RELATED information in case of an emergency. 

If you do not know the information or would like to not answer, please fill in the spaces with "n/a"
Medical Provider Information 
Reminder: If you do not know or would like to not put the information please put "N/A' in all available spaces












Ground Rules for Student Participation

During the Workshop and/or Training Camp, my student agrees to abide by the following commitments.  My student understands and agrees that if they breaks any of these commitments, they will be dismissed from the Workshop and/or Training Camp:

 


In-Person Sessions:

  1. Demonstrate constant respect for self, staff, fellow participants, and property. This includes, but not limited to, harassment, bullying, verbal abuse.
  2. No drugs, alcohol, or smoking. I agree to not consume any alcoholic beverages, use any tobacco products. If ordered by a medical practitioner to take medication, I agree to make arrangements with PeerForward staff at the beginning of the program. 
  3. No sex. I agree to not interact in a sexual nature which includes but is not limited to kissing or touching another person. I agree to not have sex with anyone during the PeerForward Summer Workshop.
  4. No leaving campus. No one should leave campus during the Workshop.
  5. Abide by curfew. I agree to be in my room at the specified times.

Virtual Sessions:

  1. Videos On - We'll look for nonverbal and verbal cues throughout the session.
  2. Be Present - Full participation via chat, polls, and breakout groups.
  3. Honor Time - Minimize the multitasking (no other windows open)
  4. Assume positive intent
  5. Be prepared for a cold call (coaches will call on you to share your experiences)
  6. Outside of designated Q&A time, put questions in the chat
  7. Demonstrate constant respect for self, staff, and fellow participants. This includes, but not limited to, harassment, bullying, verbal abuse.



Contact Information