AWARD APPLICATION FORM

Annual Mentor Recognition Luncheon 2008 Awards

Sponsored by the San Antonio Mentoring Forum and the Office of P-20 Initiatives at UTSA

Application due: Wednesday, January 2, 2008

Award Categories: We will recognize individuals and groups for their contributions to mentoring in the San Antonio area.

· Outstanding Adult Mentor – An adult that maintained an exemplary one to one mentoring relationship with a school-aged (P-12) youth within the past 12 months

· Outstanding College Student Mentor- An adult college student that maintained an exemplary one to one mentoring relationship with a school-aged (P-12) youth within the past 12 months

· Outstanding High School Student Mentor –A high school student that maintained an exemplary one to one mentoring relationship with a school-aged (P-12) youth within the past 12 months

· Outstanding Advocate for Mentoring – A school or community leader that supports one to one mentoring

· Outstanding Corporate/Business Mentoring Program – A corporation or business that supports one to one mentoring

· Outstanding School Mentoring Program – A High School, Middle School and Elementary School that has an exemplary one to one mentoring program.

Procedure: Submit a nomination form and the following:

1. A written statement (two pages maximum, typed, double spaced) of why this person or organization is being nominated.

2. A written statement from the nominee (two pages maximum, typed, double spaced) addressing such questions as:

· Why did you decide to become involved in mentoring?

· What has your experience been like?

· What has been the high point of your involvement?

3. Letters of recommendation (2)

4. Written statement from the youth mentored about the mentor being nominated. (for Adult Mentor, College Student Mentor and Youth Mentor Categories only)

5. Other supporting evidence (press releases, company newsletters etc.)

Send Application to: Belinda Saldana Dominguez, MPA

Director of Community Outreach

The University of Texas at San Antonio

501 West Durango Blvd. Room BV 1.320

San Antonio, Texas 78207-4415

Application deadline: Must be postmarked or delivered by January 2, 2008

For Addition Information: Belinda Saldana Dominguez

210-458-2904

Belinda.Dominguez@utsa.edu

Annual Mentor Recognition Luncheon 2008 Awards

Nomination Form

Nomination Category (check one):

(Submit a separate form with accompanying information for each nomination)

___ Outstanding Adult Mentor*

___ Outstanding College Student Mentor*

___ Outstanding High School Student Mentor*

___ Outstanding Advocate for Mentoring*

___ Outstanding Corporate/Business Mentoring Program**

___ Outstanding School Mentoring Program**

Nominee Information:

Individual Categories*

Name ________________________________________

Employer/School ________________________________ Position __________________________________

Address _____________________________________ Zip Code ________

Work Telephone _________________ Home Telephone _________________

Email Address ______________________

Corporate/Business/School Categories**

Organization ________________________________

Address _____________________________________ Zip Code ________

Organizational Representative __________________________ Position _________________________

Telephone _________________ Fax ___________________

Email Address _______________________

Individual/Organization Submitting Nomination:

Name ________________________________________

Organization ________________________________

Address _____________________________________ Zip Code ________

Contact Person _____________________________ Email Address _____________________

Telephone _____________ Fax ________________

Contact Person Signature ___________________________________________ Date _________________

Send Application to:

Belinda Saldana Dominguez, MPA

Director of Community Outreach

The University of Texas at San Antonio

501 West Durango Blvd. Room BV 1.320

San Antonio, Texas 78207-4415

Application deadline: Wednesday, January 2, 2008