Opening the Box: Summer 2017 Academy Chaperone

Who: Parent, school district employee, youth mentor or college student who is over the age of 21 may apply to serve as a 2017 Math and Culture Academy. Priority will be given to Sealaska shareholders but we encourage all to apply.

Opening the Box: Math and Culture Academy - June 10 to June 20, 2017 in Juneau, AK on the campus of UAS.

Job Responsibilities: Chaperones must be available to stay the entire academy as well as teleconference into the chaperone meeting, June 5, 2017. Chaperones will be with students daily. The work schedule will be agreed upon prior to the beginning of the academy. The final schedule will be released during the first Chaperone meeting.

Characteristics Needed
• Serve as a positive role model for Alaska Native youth.
• Strive for mutual respect while being an effective communicator.
• Build self-esteem and motivation to relate well with youth.

Required Responsibilities and Duties
• Be accessible by phone or designate someone who is accessible by phone at ALL times during the academy. Provide contact numbers to the SHI academy coordinators.
• Ensure that the youth are supervised at all times.
•Travel chaperones will provide transportation and supervision from the student’s home, and return the student safely to the student’s home or guardian.
• Ensure student’s prompt arrival at sign-in time; provide supervision and transportation at sign-out.
• Reside in designated student housing with students.

Other Duties
• Activities could include: mentoring -talking and listening; helping to clarify activities; encouraging participation of student in academy activities, playing games or sports, working on academy projects, and assisting in field trips.

Stipend: $1,800 for the duration of the academy. Additional funding may be provided if you are chaperoning students to the academy from a rural area along with paying for travel costs.

Apply: The deadline to complete these items is May 26, 2017
1. Complete Google drive form.
2. Send a resume and letter of intent to Jackie Kookesh at
3. Complete a SHI Consent and disclosure Form and return to Jackie Kookesh
3. Mandatory chaperone meeting date May 26, 2017. We will send a number to call in to the teleconference.

Full Legal Name
Your answer
I agree that by checking the below items I am committing to the statement.
Mailing Address
Your answer
Cell Phone
Your answer
Additional Phone Number
Your answer
Email Address
Your answer
Date of Birth
Are you currently certified First Aid and CPR?
Your answer
T-Shirt Size
Emergency Contact
Please provide name and phone number.
Your answer
Driver's Licenses Number or Alaska ID #
If you will be traveling to academy from a location outside of Juneau please provide the following information.
Your answer
Frequent Flyer Program Name and Number
Your answer
Seat Preference
(e.g., aisle, window, center)
Your answer
I understand that by submitting this form I am committing to be resident chaperone at the Math and Culture Academy.
After submitting this form please email your resume, letter of intent, along with the consent and disclosure paperwork to Jackie at
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms