Peace Learning Circles
University of Wisconsin-Parkside
P.O.Box 2000 • Kenosha, WI 53141-2000 • Phone 262-595-2402
peacelearningcircles.cfsites.org
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Peace MentorNomination
~2011 Peace Mentor Nomination Form~
International peace mentors such as Martin Luther King, Jr., Mahatma Gandhi, Cesar Chavez and Mother Teresa have made outstanding contributions toa more peaceful world. And they did it without violence. A Peace Mentor is someone who teaches others about peace. Through their words and actions they show others how to be kind, caring, and compassionate and how
to solve a problem without hurting someone else.
Peace Learning Circles would like to give our community the opportunity to highlight its own peace mentors in our program alongside these international figures. This is a chance to let our youngest Peace Mentors know that they can make a difference in their home, school, neighborhood and their world, even if only in small ways.
One of the most exciting things about this is opportunity is that anyone can be a Peace Mentor and we are reaching out to show that people in our community are doing things that are just as powerful as the national and international leaders we all hear about.
Peace Learning Circles will be accepting nominations for youth and adults for consideration as the 2011 Peace Mentors of the Year for Racine, Kenosha & Walworth counties. Applications must be returned by January 7, 2011.The chosen individuals will have their picture,a brief description of their work and a personal quote included in the PLC workbooks to promote the message of peaceful living and learning in our schools and communities.
The nominee should…
-Be a role model of kindness, caring and compassion for others, even when itis not easy.
-Stand for a specific peace promoting cause.
-Have a leadership role in that cause.
-Be able to provide a powerful quote we may use to teach students in our program.
To nominate an individual please fill out the attached form and return to:
Peace Learning CirclesQuestions?
UW-ParksideSue Hollow at
Attn. Matt Salzman (262) 939-1285
P.O. Box 2000Matt Salzman at Kenosha, WI53141-2000 (262) 595-2402
Peace Learning Circles
2011 Peace Mentor Nomination Form
2011 - Peace Mentor Nomination Form.doc
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Please consider the nomination of:
______
(First Name)(M.I.)(Last Name)
If a student: ______
(Grade)(Age)
______
(School Attending)
______
(Parental Signature) (Printed Name)
Application submitted by: ______
(Name)
______
(Phone)(Email)
Why do you believe this individual is an example of a peace mentor?
______
(over)
What do you believe is the major contribution of this nominee toward promoting peace?
______
______
______
Do you know a specific story or quote you can attribute to the nominee?
______
______
______
Can you name some other people (we may interview them) who have worked alongside the nominee toward peace?
______
NamePhone
______
NamePhone
______
NamePhone
You may attach additional information if needed, such as a brochure, flyer, or article.
Peace Learning Circles 2010-2011 • UW-Parkside – CCP • Kenosha, WI 43141
Phone 262-595-2402 • Fax 262-595-2513 •