RISE Application Form

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Please fill out these application questions

Email *

Name: *

Address, City, Zip *

Email: *

Contact Phone Number *

List Your Job Experience (if none, put N/A) *

List Your Volunteer Experience (List all services like school, church, babysitting, neighborhood helping etc.) *

Where do you see yourself in 5 Years? *

Who are your mentors or influencers in your life and how did they impact your life? *

If you could meet an influential person dead or alive, who would it be and why? *

What is one skill that you want to take away from this course that help you with your future goals? *

1. Write a one page paper OR a 2-3 min video on your 'Why' you want to take this workshop and how it would benefit you to reach your goals. When you have prepared it, check off that you will remember to send it. (you can attach it via email when you send it with all the materials. If it is a video, convert it to a YouTube link). 2. I will remember to send 2 letter of references. (one educator and one other adult ie: pastor, boss, club leader etc.) *

I will remember to send it to brigingthegapsdyslexiacenter@gmail.com

I will remember to send the two letters of reference (have them use letterhead if possible) to bridgingthegapsdyslexiacenter@gmail.com

Required

Do you have any questions for us?

A copy of your responses will be emailed to the address you provided.

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