Cynergy Fellowship Application

www.utep.edu/cce

CYnergy Fellowship Application

Contents

o Letter to Prospective Fellow

o CYnergy Fellowship Information Sheet

o Application Instructions

o Application Form

o Letter of Recommendation Form (2)

o Release and Indemnification Agreement Form

o Challenge Course Release form

Send to: Center for Civic Engagement, 500 W. University Ave. Benedict Hall Rm. 101, El Paso, TX 79968

February 09, 2009

Dear Prospective Fellow,

It is with great pleasure that we take this opportunity to introduce to you the CYnergy Fellowship for Progressive Civic Leaders of Tomorrow under the Center for Civic Engagement at the University of Texas at El Paso. This Fellowship is a great opportunity for students, such as yourself, to engage in progressive leadership training while making a difference, not only in your life, but in the lives of others.

As a young leader, you must be equipped with the proper tools to become civically responsible young adults for the advancement of society as a whole. Today more than ever, society looks upon the youth to create and mobilize change, but all too often, teens are unaware of the problems facing society and feel powerless to enact positive solutions to those challenges.

Today we call upon you to take charge and create action! Join the CYnergy Fellowship to embark on a weeklong training that will fuel your passion and give you the tools necessary for a deeper understanding of civic participation, progressive leadership, and community awareness. You will be provided the tools and skills that are necessary to spread a wave of energy across campuses and those people around you for the betterment of a democratic society.

As the next generation of CYnergy Fellows, you will acquire the knowledge and skills necessary to become great leaders and make a difference in both our community and our world. We look forward to receiving your application and learning more about your interests and talents!

Best Wishes,

Jennifer Rodriguez

Program Coordinator

CYnergy Fellowship

Center for Civic Engagement ● University of Texas at El Paso

500 W. University Ave ● Benedict Hall, Room 101 ● El Paso, TX 79968

Ph (915) 747-7969; Fax (915)747-8917

; www.utep.edu/cce

All across America the movement to mobilize, encourage, and inspire young leaders has taken the country by storm. The Center for Civic Engagement has joined this progressive force to bring a new wave of energy to El Paso through the CYnergy Fellowship.

What does the fellowship consist of?

The program consists of an intensive week of training on progressive civic leadership. The fellowship emphasizes the importance of civic awareness and action within the young adult population. The Fellowship training is structured in a cohesive four-phased configuration: Power, Awareness, Tools and Action. Students have the opportunity to participate in ropes courses, progressive leadership training, planning, as well as visiting with community leaders and organizations.

When and where does the training take place?

The training takes place at the University of Texas at El Paso during the summer starting on Sunday, June 14th through Saturday June 20th, 2009. Admitted Fellows are provided with room and board at the Miner Village Residence Halls through the entire training.

What happens after the training?

CYnergy Fellows go back to their high schools as juniors and seniors to raise a campaign of action. Fellows motivate students on their campus to address a challenge faced by their community, and throughout the year meet with the Center for Civic Engagement to begin the development and implementation of their designed CYnergy project.

How do I apply?

Faculty and staff at your campus may have application packets available for you. You may also download the packet from our website (please click link below). The Center for Civic Engagement will only choose 25-30 applicants, as space is limited. Applications are due by 5:00pm on Friday, April 17, 2009 at the office of the Center for Civic Engagement (UTEP- 500 W. University, Benedict Hall Rm 101, El Paso, Texas 79968). Once you’ve submitted your application, we may contact you to set up an interview for either Saturday, April 25th or Saturday, May 2nd.

Who may apply?

This program is offered to incoming juniors and seniors attending any El Paso County high school. Students from El Paso area high schools will be selected by the CYnergy Selection Committee. The selection of the top candidates from each school will be based on the students’ demonstration of the following six criteria: social consciousness, organizational skills, progressive leadership, academic achievement, ability to work with others and analytical reasoning.

For more information you may contact the Center for Civic Engagement at UTEP at (915) 747-7969 or via e-mail . You may also log on to our website www.utep.edu/cce

Application Instructions

We congratulate you for making the decision to apply for the 2009 CYnergy Fellowship. It is very important that you complete your application and to do so, here are the instructions and checklist.

□ Eligibility:

□ Classification: Upcoming Junior and Senior students that attend any El Paso county high school-

□ GPA: 2.0/4.0 or (75/100)

□ Time commitment:

o Participate in an interview with CYnergy Selection Committee on either April 25th or May 2nd

o Parent Orientation on May 27th, at 7:00pm- Place to be announced

o CYnergy Week: June 14th-June 20(in house/miner village)

o Fall meetings

o Spring celebration

o Creation of a year-long service-learning project

□ Application (provided) - Complete 2009 CYnergy Fellowship Application and the emergency

contact information.

□ Resume- Include your current resume of any achievements, awards and education. Be sure to list any

volunteer service you may have completed.

□ Two letters of recommendation (provided)- The Letter of Recommendation sheets need to be completed

and attached to a separate letter of recommendation that answers the four questions in the sheet about

you.

□ Personal statement- Describe the world around you—for example, your family, community or school—and how this world has shaped your progressive leadership mindset. Include examples that demonstrate how you possess the following qualities:

· Community mindedness

· Organizational skills

· Academic Achievement

· Analytical skills

· Team work ethics

Personal statement must be submitted in any of the following forms:

· Video (VHS, DVD or MiniDV)

(minimum 5 minutes / maximum 10 minutes – your high school’s media room may be helpful)

· Written essay (minimum: 2 pages / maximum: 5 pages – DS/12pt/TNR)

□ High school transcript- Your unofficial or official transcript is necessary to verify academic standing.

□ Release and Indemnification form (provided)- Your parent/guardian MUST sign the form in order to

consider your application valid.

□ Challenge Course Release form (provided)- Your parent/guardian MUST sign this form as well in order

participate in the Ropes Courses.

Applications must be submitted as a complete packet in a clasp folder. Incomplete applications will NOT be considered. If you have any questions, you may contact the Center for Civic Engagement at (915) 747-7969 or via e-mail at

2009 CYnergy Fellowship Application Form

Name: ______

Last First Middle Initial

Address: ______

Number, Street, Apartment Number

______

City State Zip Code

Date of Birth: ___/___/___ Telephone Number: ( )______

Email Address:______Cell Phone Number: ( )______

High School : ______

Gender: Male______Female______GPA: ______

Emergency Contact

Name: ______

Last First Middle Initial

Relationship:______

Address:______

Number, Street, Apartment Number

______

City State Zip Code

Work Phone: ( )______Home Phone: ( )______

Cell Phone Number: ( )______

Center for Civic Engagement ● University of Texas at El Paso

500 W. University Ave ● Benedict Hall, Room 101 ● El Paso, TX 79968

Ph (915) 747-7969; Fax (915)747-8917

; www.utep.edu/cce

Letter of Recommendation

The CYnergy Fellowship emphasizes the importance of civic awareness in the young adult population. The fellowship helps build character by giving today’s youth an appreciation of and passion for civic engagement, inspiring them to examine previously unnoticed avenues for social change. Through effective training and leadership development, the program provides the opportunity for these young adults to take the knowledge acquired back to their campuses, and use their energy to create effective civic action. CYnergy Fellows are selected based on their demonstration of the following characteristics: community mindedness, organizational skills, progressive leadership, academic achievement, ability to work well with others and analytical reasoning.

Name of Nominee: ______

Your Name: ______Telephone:______

Title: ______

Address: ______City:______State:______

□ I recommend the above referenced student to be a fellow of the CYnergy Fellowship of 2009.

Signature: ______

Please respond to the four questions asked below on a separate letter of recommendation. Sign the completed form and attach to the letter of recommendation, and return it to the student in a sealed envelope with your signature on the back flap of the envelope. The student will submit your letter of recommendation with his/her application packet.

1. Please provide the applicants full name. How long you have known the applicant and in what capacity?

2. What are the applicant’s major strengths and abilities? Please cite specific examples in which these abilities were displayed.

3. What are the applicant’s areas of improvement and development? How would this fellowship serve to heighten those qualities?

4. Please describe the applicant’s distinguished characteristics? (i.e. evidence of community mindedness, organizational skills, leadership, academic achievement, analytical skills, ability to relate to others, motivation, etc.)

If you have any questions regarding this recommendation please contact the Center for Civic Engagement at (915) 747-7969 or via e-mail . For more information you can also visit our website at www.utep.edu/cce

Letter of Recommendation

Name of Nominee: ______

Your Name: ______Telephone:______

Title: ______

Address: ______City:______State:______

□ I recommend the above referenced student to be a fellow of the CYnergy Fellowship of 2009.

Signature: ______

1. Please provide the applicants full name. How long you have known the applicant and in what capacity?

2. What are the applicant’s major strengths and abilities? Please cite specific examples in which these abilities were displayed.

3. What are the applicant’s areas of improvement and development? How would this fellowship serve to heighten those qualities?

RELEASE AND INDEMNIFICATION AGREEMENT

(Minor Student Participant)

Participant: (Name and Address) University:

The University of Texas at El Paso
Department: / Center for Civic
Engagement

Description of Activity or Trip:

CYnergy Fellowship under the Center for Civic Engagement. Will be traveling to and from
Community sites in the El Paso County area.
Location: / UTEP and various community sites / Date(s): / 6/14-6/20 2009

I am the Parent/Guardian of the above-named Participant who is under eighteen years of age and am fully competent to sign this Agreement.

I give permission for Participant to participate in the above-referenced Activity or Trip. I acknowledge that the nature of the Activity or Trip may expose Participant to hazards or risks that may result in Participant’s illness, personal injury or death and I understand and appreciate the nature of such hazards and risks.

In consideration of Participant being permitted to participate in the Activity or Trip, I hereby accept all risk to Participant’s health and of his/her injury or death that may result from such participation and I hereby release the University of Texas at El Paso, its governing board, officers, employees and representatives from any liability to Participant, Participant’s personal representatives, estate, heirs, next of kin, and assigns for any and all claims and causes of action for loss of or damage to Participant’s property and for any and all illness or injury to Participant’s person, including Participant’s death, that may result from or occur during Participant’s participation in the Activity or Trip, whether caused by negligence of the University, its governing board, officers, employees, or representatives, or otherwise. I further agree to indemnify and hold harmless the University and its governing board, officers, employees, and representatives from liability for the injury or death of any person(s) and damage to property that may result from Participant’s negligent or intentional act or omission while participating in the described Activity or Trip.

I HAVE CAREFULLY READ THIS AGREEMENT AND UNDERSTAND IT TO BE A RELEASE OF ALL CLAIMS AND CAUSES OF ACTION FOR PARTICIPANT’S INJURY OR DEATH OR DAMAGE TO PARTICIPANT’S PROPERTY THAT OCCURS WHILE PARTICIPATING IN THE DESCRIBED ACTIVITY OR TRIP AND IT OBLIGATES ME TO INDEMNIFY THE PARTIES NAMED AND FOR ANY LIABILITY FOR INJURY OR DEATH OF ANY PERSON AND DAMAGE TO PROPERTY CAUSED BY PARTICIPANT’S NEGLIGENT OR INTENTIONAL ACT OR OMISSION.

______Date: ______

Signature of Parent/Guardian

______

Address, if different than Participant’s

______Date: ______

Witness