STEP 1: PEER GUIDE APPLICATION FORM

Who are we looking for? "We’re looking for survivors, who have faced challenges and have had life experiences that have helped them become stronger” Sonwai W.

Peer Guides are Native youth coming together to create community support for those impacted by the Juvenile Justice system. Together they will inspire other youth to engage in cultural prevention to heal our homes.

Are you passionate about making a difference for Native youth? Have you, a family member or friend been impacted by the juvenile justice system? Would you like to join a team of peers, like minded, to work together to reach out to advocate for positive change and prevention programming? If so, this program is for you!

Application Process:
Applicants must complete the online application form prior to the noted deadline. Please note that only online submissions will be accepted for consideration.

Nomination Process:
Applicants need to find a nominator. A nominator can be a family member; such as parent, grandparent, sibling, aunt, uncle or guardian or a mentor, teacher, coach, supervisor, counselor or friend.
Nomination form: https://goo.gl/forms/1mXOE5VpLGwnGeam2

Due Date
Applications must be received in the UNITY office by 11:59 pm (Mountain Standard/Pacific Daylight Time) on Wednesday, April 17, 2019.
The selections to the 2019-2021 class of the UNITY Peer Guide Leadership Program will be announced by May 1, 2019.

To learn more information about the the Peer Guide program and Application process visit the link:
https://unityinc.org/learn-more-about-unity-peer-guide-program/

If you have questions, contact:
LorenAshley Buford, Program Manager - la.buford@unityinc.org or
Tami Patterson, Program Coordinator - t.patterson@unityinc.org or
call the UNITY office at (480) 718-9793.

This Initiative is supported by a cooperative agreement (2018-TY-FX-K002) between UNITY, Inc. and the US Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention.

Name *
Have you, a family member or friend been impacted by the juvenile justice system, substance abuse or child welfare system? If so, please share how this experience will assist your contribution as a Peer Guide and mentor to other Native youth: *
How do you think cultural prevention could help Native youth keep out of trouble in your community? *
What would you tell a Native Youth who struggles to see themselves as a leader? *
What personal and/or leadership qualities do you have that would be of most value if selected as a Peer Guide? *
What obstacle or challenge have you overcome in your lifetime that you are most proud of? *
What are the top three issues of concern in your community facing those impacted by the juvenile justice system? *
Think about a project you might like to undertake to address the above mentioned issues. Describe the role that you might potentially play if your project were to be implemented. *
Describe learning experiences outside the classroom that were important to you? [This may include a community service project, realizing a work of art, playing on a team, playing an instrument or cultural dance, etc.] *
Where do you see yourself in five years? *
Describe a role model that has influenced your life? How have they contributed to your personal growth and development? *
Have you ever facilitated a training? If so, briefly describe your experience: *
Why is it important for peer leaders to live with integrity and act as a role models even when outside of a peer leadership program? *
Please provide a high resolution head shot picture. No Selfies. If chosen, this photo will be used for publication: *
Required
Prior UNITY Involvement (not required to apply )
I am 18 years - 24 years old *
Date of Birth: *
MM
/
DD
/
YYYY
Tribal Affiliation: *
Which Region do you live in currently? *
Youth Address: *
Youth Email Address: *
Youth Contact Phone: *
(Emergency Contact) Parent, Guardian, or Advisor Name: *
Parent, Guardian, or Advisor Email Contact: *
Parent, Guardian, or Advisor Phone Number: *
By digitally signing your name, you agree that all the information given is truthful. Type your full name below. *
Submit
Never submit passwords through Google Forms.
This form was created inside of United National Indian Tribal Youth, Inc.. - Terms of Service