Partners for Youth

and

are merging to become….

Partnering with the community to provide Durham youth withopportunities to connect, develop, and

contribute through mentoring, employment, and educational support.

Dear Student,

Thank you for your interest in the Partners for Youth Opportunity! If you want to go to be a part of a year-round program that offers mentoring, educational support, and workforce development, we want to hear from you!

Please complete this application packet if you area Durham resident, 8th-12th grade,typically 14-17 years old at enrollment,and:

1) Qualify for free/reduced lunch at school or have a current Medicaid card(if you have not applied for

free/reduced lunch but think you are eligible you can apply at school.)

We prioritize students who also have one of these additional qualifying factors:

2) Child of a first generation immigrant

3) Have an environmental or home risk factor

4) Have a parent previously or currently incarcerated

Partners for Youth Opportunity (PYO) is the product of a merger between YO:Durham (Year of Opportunity for Durham Teens), and Partners for Youth, two organizations that have served a similar population of youth for the past several years. The combined organization works with at-risk youth between 8th-grade and college. Our goal is to foster improved resiliency among our students while connecting them to social and economic opportunities. The core components of our program are mentoring, workforce development, and educational support.Partners for Youth Opportunity specializes in helping high school students learn life skills, job skills, and get the support they need to prepare for and afford college.

If you join Partners for Youth Opportunity, we will encourage youto remain in the program until you have completed your first year of college. Our student body is made up of youth who have been in the program for varying lengths of time, depending on when they enrolled in eitherPartners for Youth or YO:Durham.

To begin the process of applying to PYO, fill out the student application, have your parent fill out the parent recommendation, and an adult who knows you well to complete the recommendation form. Turn in the student and parent forms by emailing them to , or mailing them to 1309 Halley Street, Durham, NC 27707. After we receive your application, you and a parent or guardian will be invited to a 30 minute interview with the Executive Director.

Please contact me at 919-536-4230 if you have any questions. I look forward to receiving your application!

Sincerely,

Julie Wells

Executive Director, Partners for Youth

and

are merging to become….

Student Application

Name ______

Address ______Zip ______

Home phone______cell ______Date of Birth ______Age now ______

Email ______Parent’s email ______

Mother/Guardian’s name______

Address ______home phone______

Mother/Guardian’s occupation ______cell phone ______

Father/Guardian’s name______

Address ______home phone ______

Father/Guardian’s occupation ______cell phone ______

School you currently attend ______grade ______

Middle and elementary schools you attended ______

______

______

Community and religious groups you are a part of (your church, sports teams, etc.)

______

______

What do you do in your free time? ______

______

What is your favorite class or thing to study in school? Why?

______

______

What is your least favorite class or thing to study in school? Why?

______

______

What do you do when a class is hard for you? ______

______

Name someone you admire and describe why.

______

______

______

What are your goals for the future?

______

______

Briefly describe why you want to join Partners for Youth Opportunity. ______

______

______

Who were your teachers last year? ______

______

You can submit your application by email to or bring it to the Community Family Life and Recreation Center at Lyon Park or mail to: Julie Wells, PYO, 1309 Halley Street, Durham, NC

For More Information, contact Julie Wells at 919-536-4230 or

and

are merging to become….

Student Recommendation Form

Dear Community member,

The student who asked you to complete this form is applying to participate in a program called Partners for Youth Opportunity. It is a year-round, multi-year program that requires continuous participation and a genuine commitment from our students. PYO students are tutored twice/week by Duke student tutors, have an adult mentor in the community, a mentor at school, and a job-based mentor at an internship. Your answers to the following questions will help the program staff identify the students best suited for the program. We are looking for at-risk students who are motivated and who, with support, could graduate from high school and attend college. Please share any advice/information you think might be helpful. Please do not return this form to the student. Please, either: 1) Email it to r 2) mail it to (Julie Wells, PYO, 1309 Halley Street, Durham, NC 27707). Thank you very much for your time and attention. If you have a question, please contact Julie Wells at 919-536-4230 or .

Applicant’s Name ______

Your Name ______

Your email ______

Please circle the response which best describes your opinion regarding the following statements.

1) The youth is internally motivated to succeed and accepts support and help when offered.

alwaysmost of the timesometimesnever

Comments ______

______

2) The youth is respectful and able to accept feedback about their behavior.

alwaysmost of the timesometimesnever

Comments ______

______

3). Tell us a little about your relationship with this youth.

Comments ______

______

4). What do you think this youth’s greatest strengths are?

______

______

5) I think this student could graduate from high school and attend college with the proper support.

definitelyprobablymaybedoubtful

______

______

6) What are the challenges this youth face, either internally or environmentally?

______

______

7)Have you had any contact with the student’s parent or guardian? yesno

If yes, would you characterize your interaction as:

positiveneutralnegative

Comments ______

______

6) Is there anything that we have not asked that would be helpful for us to know in assessing this student’s appropriateness for the program?

Comments ______

______

THANK YOU!

and

Are merging to become…

Parent/Guardian Information For ______

Dear Parent,

This is an application for your child to join a multi-year program called Partners for Youth Opportunity. Please read the cover letter of this packet that explains who is eligible to apply. We are looking for students who want to go to college and are willing to work hard to get there. Your child must be motivated to attend so talk with them about it before you submit an application.

YOUR CHILD’S NAME______

YOUR NAME: ______

1) Why would your child benefit from participating in Partners for Youth Opportunity?

Comments: ______

______

2) Which pieces of the program are you hoping your child will receive and why:

______

______

3) My child gets along with other people his/her age.  True False

My child gets along with adults. True False

Comments:______

______

3) These are the words I would use to describe my child:______

______

4) When my child grows up, I hope he/she is ______

______

5) My child’s strengths are: ______

______

6) My child needs help with:______

______

7) I want you to know this about my child:______

______

8) Because PYO is designed to help disadvantaged children, we must ask you for some sensitive information. All information disclosed will be kept confidential. Please check any that apply:

 My child receives free/reduced price lunch at school.  My child is a recent immigrant.

 I have a current Medicaid card for my child.  My child has medical issues.

9) Do you understand that you are a partner in this program- your child will need your help with transportation to take advantage of opportunities? Check one:

Yes ______I can’t help with transportation ______

10) If you need to contact me, I can be reached at: home phone: ______

Cell phone: ______Email: ______.

10) I give permission for the information listed below regarding my child, to be released to the staff of PYO.

(child’s full name) ______(date of birth) ______, to be released by (name of school last year) ______. I understand that PYO will be responsible for its continued confidentiality. This release is valid for one calendar year.

Information to be released to: Staff and volunteers of Partners for Youth Opportunity Program. I give my permission for the staff, teachers and administrators of the school listed above to release all records and information (verbal or written) pertaining to my child, to the staff and volunteers working with the Partners for Youth Opportunity program. This information will include my child’s grades and academic transcript for the 2013-2014 school year, the record of my child’s behavior at school (suspensions, etc.) and eligibility for free and reduced lunch.

Signed by:______Date ______

(Circle one) Parent/ Legal Guardian/ Surrogate Parent/ Student over age 18

Witnessed by: ______(ask another adult to witness your signature and sign here)

THANK YOU!

Please return this form to Susan McCraw,

or mail it to PYO, 1309 Halley Street, Durham NC 27707

For More Information, contact Julie Wells at 919-536-4230 or