Positive Peer Influencers
This form provides an overview of the Positive Peer Influencer program, parent permission for a student to be trained as a Positive Peer Influencer and provide Making Positive Choices sessions to middle school students, and consent to photography.

Please email youth@mediationsavannah.com with any questions.
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Youth are faced with making decisions on a daily basis, however, sometimes they lack the experience, knowledge, information, and skills needed to make safe informed decisions.  The Savannah-Chatham County Public School System, The Mediation Center of Coastal Empire, Inc., and Chatham Narcotics Team are partnering to implement “Positive Peer Influencers”, a mentoring program created from evidence-based practices and research using high school students to bring the message of the importance of making positive choices to youth in middle school.  High school youth who have demonstrated leadership, exemplary communication, and positive decision-making skills are selected to help their fellow students develop these life skills. 

By granting permission for your high-school student to participate in the Positive Peer Influencer program, you agree for your student to participate in Positive Peer Influencer training. The training is guided by seasoned educators and professional social workers.  The training includes

* role plays and other interactive methods

* decision-making strategies and behaviors to make positive choices

* refusal strategies to resist peer pressure

* communication skills such as active listening 

* dangers of fentanyl and other substances

* group discussions to share ideas and personal opinions, and clarify specific areas of concern where youth are faced with making decisions, especially with regard to risky behaviors, i.e. substance abuse, friend choices, social media, etc. 

There will multiple training sessions.

Once training is complete, students will be assigned dates to facilitate the Positive Peer Influencers curriculum at their feeder middle schools, specifically with the intent of supporting youth to make empowering decisions; to resist negative peer pressure and reflect on the consequences of bad choices.  

Positive Peer Influencers will travel to middle schools to build relationships, provide presentations, and other activities throughout the school year.

Please be advised youth may be on video and photographed during training and when performing the PPI role.  

Students Grade *

Name of student applying to be a Positive Peer Influencer:

*

Email address of student:

*

School student attends:

*
Was the student a Positive Peer Influencer last school year? *
Does student have their PPI shirt? *
Shirt Cut  *
Student Shirt Size  *

Name of parent/guardian:

*

Parent/guardian email address:

*

Parent/guardian phone number:

*
Please acknowledge each of the following: *
Required

Participants of the Peer Influencer Program may be photographed and/or recorded by The Mediation Center for the following purposes:

* Conference presentations

* Educational presentations or courses

* Informational presentations

* On-line educational courses

* Educational videos

* Promotional material

* The Mediation Center’s social media pages

If you have any questions, please email the Mediation Center, youth@mediationsavannah.com.

We look forward to working with your student and training them to become solution-oriented change-makers in SCCPSS schools.
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