Address
Zip
Cell Phone
select from list
Abby Kelley Foster Charter Public School
Auburn High School
Bancroft School
Burncoat Senior High School
Claremont Academy
Doherty Memorial High School
Grafton Memorial High School
Holy Name HS
Leicester High School
Mass Academy of Math and Science
Millbury Memorial High School
North High School
Notre Dame Academy
Shrewsbury High School
South High Community School
St. John's High School
St. Mary's Jr./Sr. High School
St. Peter-Marian Jr./Sr. High School
Tahanto Regional Middle/High School
University Park Campus School
Wachusett Regional High School
West Bolyston Middle/High School
Worcester Academy
Worcester Vocational High School
If High School is not listed
Parent or Guardian Daytime Phone
Parent or Guardian Evening Phone
Employment
Do you currently have a job?
No
Yes
If yes, where?
What is your weekly work schedule?
Ethnicity
Do you consider yourself part of a particular ethnic/cultural group?
(Optional)
No
Yes
If yes, please identify
Questions
1.
What was your favorite thing about being part of YCI last year?
2.
What did you learn?
3.
How did you grow as a leader...
In your family?
At school?
In your community?
As a global citizen?
4.
Who are your top three mentors and/or role models?
5.
In your opinion, what characteristics do good mentors possess?
6.
Have you ever served as a mentor? If so, please describe your position and your experience.
7.
Based on your experience in YCI last year, please explain how your group skills and communication have improved, and why that might be important as you begin to think about college and a career?
8.
What did you find most difficult and/or confusing about YCI that you would like a deeper understanding about this year?
9.
What else would you like to learn about youth philanthropy (grant giving) and leadership?
10.
There is an expectation that selected YCI members attend all meetings between January and April. With the exception of one Saturday retreat scheduled for January 9, 2010 (snow date January 16th), meetings will be held every Tuesday (January 19th through April 6, 2010) from 4:30-7:30 pm at Greater Worcester Community Foundation, 370 Main Street, Suite 650 in Worcester. YCI members will also need to complete a qualified community service project (4 hour minimum plus a one-page written summary) by March 30, 2010.
Are you able to commit to the above expectations?
No
Yes
If no, please list your conflicts or scheduling concerns
Youth for Community Improvement
Philanthropy in Action