TEENS IN ACTION APPLICATION
The student and a parent will need to complete this form together. Original signatures will be required upon selection to the program.
Criteria
- Applicants for Teens In Action (TIA) must be rising into grades 9 through 12 and live and/or go to school in Hillsborough County.
- Nominees must have the full support of their parent/guardian(s)
- Applicants will submit two letters of recommendation from adults familiar with their character and commitment to growth (i.e. teacher, pastor, coach)

In reviewing applications, the Selection Committee looks for potential participants who demonstrate:
- A desire to learn social and emotional learning (SEL) concepts and skills
- A strong commitment to community service and learning about the projects they will support.
- The ability to make the time commitment required by the program.

Upon final consideration, applicants will be contacted for a personal interview.
- If selected, applicant must adhere to program standards (see below).

Please review the required dates of participation prior to applying for this program (***see TIA calendar link below***).
- Attendance at the SEL Bootcamp and closing graduation is mandatory.
- Attendance at all workshops and weekly volunteer projects is expected.

IMPORTANT NOTE*: Those who fail to attend the SEL Bootcamp or miss more than two workshop sessions will be dropped from the program.

*The only exceptions to this policy will be related to health and/or safety, must accompany a doctor’s note and obtain written approval from the TIA program manager or other Frameworks leadership.

*Participants who identify a conflict with attendance requirements will be offered a refund only if withdrawal is accomplished prior to the SEL Bootcamp and a waitlist participant can fill the vacancy.

CHECK THE 2016-2017 TIA TENATIVE CALENDAR FOR PLANNING PURPOSES: Not Available Yet

Program Standards
The mission of Teens In Action (TIA) is to empower young people to make a genuine and meaningful difference in their community by breaking barriers between themselves and others.
The purpose of Teens In Action is to teach youth, through service learning, the social-emotional concepts and skills that will help ensure their success in all aspects of their lives, both as youth and as they become adults.

In order to achieve this, selected class members are expected to:
1. Fully and actively participate in each program.
2. Demonstrate respect for staff, leaders, program guests, and fellow program members.

First Name: *
Your answer
MI:
Your answer
Last Name: *
Your answer
Name you want to be called: *
Your answer
Date of Birth: *
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High School: *
Your answer
Current Grade Level: *
T-Shirt Size: *
Street Address: *
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City: *
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Zip: *
Your answer
Cell Phone: *
Your answer
Email: *
Your answer
Parent / Guardian Name/s: *
Your answer
Parent / Guardian Address (if different):
Your answer
City:
Your answer
Zip:
Your answer
Parent / Guardian Phone: *
Your answer
Parent / Guardian Email: *
Your answer
Referred By: *
Your answer
Will participant be applying for financial assistance? *
Required
Would you be willing to provide a sponsorship for Teens In Action *
This is in addition to your student tuition
This section is for demographic data collection purposes only.
Instructions: Please select the answer the best represents you.
Gender:
Race/Ethnicity:
Candidate Involvement
In order of importance to you, list three recent volunteer activities in which you have been actively involved:
Organization:
Your answer
Position:
Your answer
Describe Responsibility:
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Organization:
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Position:
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Describe Responsibility:
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Organization:
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Position:
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Describe Responsibility:
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How did you exhibit leadership in one of the above organizations? What are the results?
Your answer
How much time do you commit to volunteer activities each month?
Your answer
If you have not had time to become actively involved in a volunteer initiative, what conditions have changed that now enables you to seek involvement in the community?
Your answer
What has been your greatest accomplishment as a student or volunteer? *
Your answer
What are you passionate about? *
Your answer
What interests you about the Teens In Action program? *
Your answer
What after school activities do you plan on being involved in? (i.e. sports, band, enrichment) *
Your answer
Candidate Commitment
As a high school student, we know you are extremely busy with school, clubs, sports, and possibly a job. We also recognize your desire to serve your community. Please review the following requirements to determine if you are able to commit at least 10 hours per month to the Teens In Action program.

• Attend SEL Bootcamp
• Attend closing graduation ceremony
• Miss no more than 2 program workshops
• Attend individual team project meetings August through April
• Pay non-refundable program fee of $350
• Participate in a Teens In Action led fundraising initiative/s to help support the Teens In Action program

*Financial Assistance: Scholarship monies are available. If you are interested in program fee assistance, contact Lisa Rose, Program Manager, at 813.514.9555, ext. 108 or TIA@myframeworks.org prior to the application deadline.

I understand the commitment to the Teens In Action program. If selected, I will devote the required time and pay the non-refundable program fee.

Parent Commitment
Part of the intent of the Teens In Action program is to provide your student with life skills needed to succeed in the world. We provide opportunities to practice Social and Emotional skills through volunteering, during workshops, and via regular communication with your teen. Your student will grow and learn through doing.

With those goals in mind, our expectation is for YOUR STUDENT to communicate with staff and leaders regarding most issues related to the TIA program (i.e. scheduling, challenges, and advice).

We always welcome your feedback and support! However, please refrain from communicating on their behalf unless it's physically impossible for them to do so. It's good training for them.

A calendar will be provided prior to acceptance into the program, please review the criteria and candidate commitment sections of this applications to determine if TIA is a good fit for your student.

Media Consent and Release
I hereby irrevocably consent to and authorize the use, publication, and reproduction at any time by Frameworks of Tampa Bay, Inc., or anyone it authorizes, of any and all photographs taken of me or my child or both me and my child, as the case may be, with or without names, for any editorial purpose, promotion, advertising, trade, or other purpose whatever.

I understand that the photographs or videos may be used in any or all editions of Frameworks of Tampa Bay, Inc.’s communications to accompany or illustrate a story about social and emotional learning and/or programs. I realize that this coverage may place my picture, with or without further explanation, alone or accompanied by other pictures, in a story, in or on a cover of any or all editorial content, depicting, describing, or illustrating its programs and/or social and emotional learning. I recognize that such use may place me in a very unfavorable light.

I hereby consent to such depictions, and release Frameworks of Tampa Bay, Inc., its directors, officers, agents and employees, or anyone it authorizes, from any and all claims whatsoever relating to or arising from the uses consented to above.

I am over 18 years of age, and have read this consent and release, or have had it read and explained to me in my native language, fully understand its contents, and enter into it voluntarily and without coercion.

Select one: *
Required
Special Considerations
Please describe of any special considerations we should be aware of to best support the applicant (i.e. allergies, physical limitations, etc.)
Your answer
Additional Requirements
Email the following items to complete your application:
- Headshot (.pdf or .jpg similar to a profile picture to be used in your files)
- Two letters of recommendations from unrelated adults over 18.
Send to TIA@myframeworks.org
Applications without these items will not be considered.
Candidate Participation Consent and Release
Permission for Enrollment and Release of Frameworks of Tampa Bay, Inc. from Liability:

I am an adult over 18 years of age and I give my child permission to participate in Frameworks activities. I understand that even when reasonable precaution is taken, accidents can sometimes still happen. Therefore, in exchange for Frameworks allowing my child to participate in Frameworks activities, I understand and expressly acknowledge that I release Frameworks and its staff members and board for all liability for any injury, loss or damage connected in any way whatsoever to my child’s participation in Frameworks activities whether on or off the Frameworks premises. I understand that this release included any claim on negligence, action or inaction of Frameworks, its staff, directors, board members and guests. I have read and am voluntarily signing this authorization and release.

I HAVE READ THIS FORM AND GRANT PERMISSION FOR MY CHILD, Name Listed Above, TO PARTICIPATE IN ALL ACTIVITIES PROVIDED BY Frameworks. By signing this form, I state that I am the legal parent/caregiver of the minor child listed above and authorized to grant such permission.

Digital Signature
On the final step you will be required to enter a digital signature which will be binding as your actual signature. Your electronic signature below indicates your agreement with the following statements

By typing my initials in the following box I certify the above statements to be true and correct, to the best of my knowledge, and that this information can be used for the purpose of processing my application and information for consideration in the Teens In Action Program.

I also acknowledge the commitment needed for Teens In Action and the required attendance. I will take personal responsibility for the outcome of my TIA experience.

Date: *
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Participant's Initials *
Your answer
Parent's Initials *
Your answer
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