SafeSpace Peer Support Squad Application for Middle Schoolers
SafeSpace is a youth-led, mental health focused organization that empowers young people to engage openly with their local schools and communities. We create and implement initiatives to lead the conversation around mental health by educating and encouraging our peers to speak up, support others, and seek help when needed. To learn more: SafeSpace

CALLING ALL MIDDLE SCHOOLERS TO APPLY AND JOIN OUR PEER DRIVEN PILOT PROGRAM! 
SafeSpace is excited to announce the highly anticipated Peer Support Squad (PSS)!
WHAT IS PEER SUPPORT SQUAD?
It's a peer-driven pilot program that matches middle schoolers with high schoolers, a 1:1 pair!
Each pair will decide what works best for them when it comes to meeting the weekly check-in requirements. PPS is here to support you in the most comfortable and efficient way whether it's texting, staying connected via social media, FaceTime, meeting up at a local spot in the community, or talking on the phone. 
WHY IS PSS IMPORTANT?
*Middle school can be challenging and having a high school buddy that can empathize can make a big difference in your experience.
*Sometimes middle schoolers just want to have open conversations with someone who isn't an adult or "authority" figure.
*Being a part of the Peer Support Squad can allow everyone to be seen, heard, and validated
--
Applications are open August 1, 2023 - September 30, 2023
All applicants will be notified in October.
Open positions for middle schoolers: 15 available spots
Program commitment: attend 6 monthly meetings in January 2024 - June 2024
Monthly meeting dates will be announced on our website by August 30, 2023
Parent / Guardian consent is required to participate in our program.
*** There is no cost or fee; all services and supports are free of charge ***

TO LEARN MORE: visit our website; FAQs are posted! 
Questions, please do not hesitate to connect with us at: info@safespace.org



Email *
TODAY'S DATE (NOT date of birth): *
FULL NAME: *
PRONOUNS: *
WHAT IS YOUR SEXUAL ORIENTATION? *
GRADE LEVEL (2023-24): *
MIDDLE SCHOOL: *
WHAT CITY DO YOU LIVE IN? *
WHAT IS YOUR PRIMARY LANGUAGE SPOKEN AT HOME? *
I'M INTERESTED TO LEARN MORE ABOUT: (check all that apply; more than 1 box can be checked) *
Required
MY HOBBIES: *
Required
WHAT IS YOUR FAVORITE ICE-BREAKER QUESTION? *
I AM AN: *
MY BEST FRIEND WOULD DESCRIBE ME AS (one word): *
I CAN'T LEAVE HOME WITHOUT___________________. *
WHAT IS YOUR PET-PEEVE? *
WHO IS YOUR FAVORITE SINGER/BAND? *
WHAT MAKES YOU SMILE? *
WHAT ARE SOME IMPORTANT QUALITIES A HIGH SCHOOL PEER SUPPORT LEAD (AKA BUDDY) SHOULD HAVE?  *
MY PREFERRED COMMUNICATION METHOD(S) ARE:  *
Required
WHAT ARE SOME WAYS YOUR FRIENDS SUPPORT YOU THAT YOU APPRECIATE? *
FILL IN THE BLANK: _____________________ IS MY SUPER POWER! *
WHAT IS AN AREA OF GROWTH YOU WANT TO WORK ON THIS YEAR? *
WHO IS YOUR BIGGEST FAN? *
TELL US A LITTLE ABOUT YOU AND WHAT MADE YOU INTERESTED IN JOINING OUR PEER SUPPORT SQUAD? *
DID WE MISS ANYTHNG? LET US KNOW :)
THANK YOU! WE REALLY APPRECIATE YOUR TIME AND LOOK FORWARD TO LEARNING MORE ABOUT YOU. REMEMBER TO CHECK OUR WEBSITE FOR MORE INFORMATION AND UPDATES ON THE PROGRAM. PLEASE DO NOT HESITATE TO REACH OUT TO US: info@safespace.org
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of SafeSpace. Report Abuse