Personal Rotary Youth Development Experience

Personal Rotary Youth Development Experience

Student Registration Packet

Contents:

Sample Selection Procedures

Sample Interview Questions

Sample Interview Scoring Form

Sample Participant and Alternate letters

Registration Cover Letter (PRYDE Form A)

Student Packet

PRYDE Information Sheet (PRYDE Form B)

Application (PRYDE Form C)

Camp Information/ What to Bring (PRYDE Form D)

Registration Form (PRYDE Form E)

Medical and Liability Release Form (PRYDE Form F)

Code Of Conduct Form (PRYDE Form G)

Rotary District 5330 Contacts:

PRYDE Chair-

Kimberly Braswell

951-314-3285

951-213-2120 Fax

Registration-

Barry Braswell

951-323-6522

951-213-2120 Fax

Sample of Selection Procedures:

1. If you have not done so, submit the Club Reservation form to Kimberly Nunn. The form is due January 31, 2014 along with your check. This form indicates the number of students your club will sponsor.

1. Submit club payment checks, $230 per camper to the PRYDE Chair no later than January 31, 2014: Kimberly Nunn, 1040 S. Mt Vernon Ave G-153, Colton, CA. 92324. Please make checks payable to Rotary District 5330.

1. Contact junior high school staff (administrators, counselors, teachers, student government advisor, and/or coaches), and ask them to recommend seventh graders who would benefit from a weekend of leadership training and experiences.

1. Set up a meeting with the recommended students, preferably at the school. Distribute the PRYDE Fact Sheet (Form B), and introduce Rotary and the PRYDE weekend opportunity, Saturday, May 17 through Sunday, May 18, 2014. Emphasize the dates and length of time commitment that the students must make if they wish to apply to attend PRYDE. The weekend is planned with inter-related activities. They are not allowed to arrive late or leave early.

1. At the conclusion of the meeting, give the students the Application Form (Form C), and directions for completing and returning it to the Club. You may arrange for school staff to collect and return them, or have the applicants return them by mail to the Rotary Club PRYDE Chair.

1. Schedule interviews with the applicants. Remember, it is not necessary to select the student with the highest grade point average, but the student who will contribute or benefit the most from the PRYDE experience. Emphasize with the student that they are making a commitment for the entire weekend. You may use the Sample Questions, and Sample Scoringthat follow. The questions may be about anything that is appropriate, such as local, national, and international events, values, and experiences. Complete an interview-scoring sheet for each person to aid in making your selections.

1. PLEASE CHOOSE EVEN NUMBERS OF MALE AND FEMALE STUDENTS. PLEASE CHOOSE CAMPERS AND ALTERNATES.

1. When the final selections are made, notify the students by mail. Please see the sample selection and rejection Letters. Include in the letter of those selected:
2. (Form B) PRYDE Fact Sheet
3. (Form D) What to Bring to Camp
4. (Form E) PRYDE Registration- Please include sponsoring Rotary Club
5. (Form F) Medical & Liability Release
6. (Form G) Code of Conduct
7. Have the students return the completed forms to their school contact, or the club PRYDE chair.

1. It is very important that alternate candidates be selected in the event that one of the original students is unable to attend. This occurs frequently. The alternate's paper work is due at the same time as the primary attendees. If there is space available due to early cancellations, alternates are picked by the registrar to accommodate bus loads, cabin assignments, etc., so be sure to rate your alternates (first alternate female - first alternate male and so on)

1. When the Rotary Club has received all the completed applications (Form E, Form F andForm G), and checked them for accuracy and signatures (the parent or guardian must sign the bottom of the release and the student must sign the code of conduct), The Rotary Club should complete the cover sheet (Form A) and send them to the PRYDE Registrar:

Barry Braswell, 1040 S. Mount Vernon Ave. G-153, Colton, CA. 92324

Phone: (951) 323-6522 Fax: (951) 213-2120 Email:

All Forms Must be received by March 15, 2014

Return:

1. (Form A)Cover Sheet
2. (Form E) PRYDE Registration
3. (Form F) Medical & Liability Release
4. (Form G) Code of Conduct

1. Please rank the alternates in the order that you wish them to be chosen. Please verify that all information on the permission slips is legible.

1. Arrange for your PRYDE participants to attend at least one Rotary Club meeting before their camp experience so that they will have some basic idea of what Rotary is all about.

1. The “Bus Letter” will be mailed to the registered participants on or about April 30, 2014 telling them the exact time and location of bus pickup. If participants miss the bus, they will be unable to attend PRYDE. Entry to camp will be denied to students not arriving on an assigned bus due to insurance issues. The letter will also tell them what to bring, (i.e. sleeping bag, pillow, towel).

1. Keep in touch with the participants and alternates. Notify the registrar immediately if you learn that a participant or alternate is unable to attend. Confirm the name of the alternate with the registrar when there is a replacement. Contact the alternate and inform him/her that s/he is invited to attend. Provide the alternate the name of the person and the bus stop of the person s/he is replacing. The alternate is to use that name to get on the bus and to check-in at camp registration.

1. Your Rotary club is responsible to have one Rotarian at your participants’ bus stop at the time of departure on Saturday morning and upon their return on Sunday. The bus cannot drop off the participants at the bus stop on Sunday if there is no adult present. Please have a Rotarian there.

1. After PRYDE, invite the participants to a meeting soon after their weekend so that they can share their experience with your club.

1. Thank you and have a great PRYDE experience.

District 5330

PRYDE

Sample Interview Questions

1.What are your plans for the next year? Five years from now? Twenty years from now?

1. What are your three most important ideals or values?

3.Who has been the most important person in your life? Whom do you admire outside your family?

4.If five candidates, including you, are equally qualified, why should you be selected?

5.If you could make one major change in your school, what would it be?

6.What would each of the following individuals say were your three most important characteristics?

A.Parent

B.Your English Teacher

C.A Close Friend

D.Yourself

1. Outside of your classes, what activity has been most important in terms of your personal growth?

SAMPLE EVALUATION FORM

Evaluation for (Name)

Score 4 3 21

Excellent Good Fair Poor

Evaluation Qualities / Score 1-4 / Question Weight / Multiply Score X Weight
Appearance:Dress,
Gesture, Movement, Eye Contact / 1
Presentation:Expression, Direction, Self Confidence / 2
Leadership:Variety and Extent of Offices / 3
Quality of leadership position / 4
Listening Skills: Attentiveness,
Appropriateness of Response / 4
Goals:Clarity, Realism / 4
Values: Clarity of Definition, Breadth, Depth / 4
General Overall Evaluation / 3
Total (Weights x Score for each, all added): Maximum (100)

Comments:

Personal Rotary Development Experience

District 5330 – (Your Rotary Club)

Sample Selection Letter

Mr. Josh Smith

123 4thSt

Corona, Ca 91719

Dear Mr. Smith,

CONGRATUATIONS! This letter is to inform you that you have been selected to attend the Personal Rotary Youth Development Experience (PRYDE) Conference on May 17-18, 2014.

The Rotary Club of______is your sponsoring club, and they will be paying your fees. Please fill out, and have your parents/guardian sign the PRYDE Registration form, and you must sign the Code of Conduct form.

Please mail these forms to me, or return them to your school contact by March 01, 2014. You will receive a letter from PRYDE, on approximately April 30, 2014, telling you of the exact time and place of bus pick up on Saturday May 17, 2014. The letter will also give you suggestions as to what to bring to the camp. (I.e. sleeping bag, pillow, flashlight, washcloth and towel.)

We wish to thank you for participating in the application and selection process. We hope you will make the most of this learning experience

Sincerely,

Sample Rejection Letter

Dear Mr. Smith,

The qualities of applicants applying to attend this year's Personal Rotary Youth Development Experience (PRYDE) Conference were truly outstanding. Unfortunately, we must inform you that you were not selected to attend.

We thank you very much for taking the time and effort to prepare your application and to participate in the interview. No one achieves everything they apply for, and we encourage you to continue to pursue the various other opportunities, which will undoubtedly be coming available to you.

We wish you every success in the future.

Sincerely,

(You may want to add a paragraph if they are selected to be an alternate. Ask them to please complete the forms and that they will be notified if the space for them to attend camp becomes available)

Alternate Forms are due with the chosen students and will not be accepted after the deadline.

Personal Rotary Youth Development Experience

Registration Packets are due by March 15, 2014

Registration Cover Letter

Please complete and submit with the student registration packets to

Barry Braswell

1040 S. Mt Vernon Ave., G-153

Colton, CA. 92324

951-213-2120 Fax

Rotary Club of ______

Contact Name ______Phone______

First Name / Last Name / Address / City/Zip / M or F / Camper or Alternate

(PRYDE Form A)

Personal Rotary Youth Development Experience

PRYDE FACT SHEET

WHAT IS ROTARY INTERNATIONAL?

Rotary is an organization of business and professional leaders united worldwide, who provide humanitarian service, encourage high ethical standards in all vocations, and help build goodwill and peace in the world. Rotary is the world’s first service club, founded in Chicago, Illinois, in 1905. It now has over 1.2 million service-minded men and women belonging to nearly 27,000 Rotary clubs in virtually every nation in the world. Rotarians plan and carry out a remarkable variety of humanitarian, educational, and cultural exchange programs that touch people’s lives in their local communities and our world community.

WHAT IS PRYDE?

The Personal Rotary Youth Development Experience is a two-day leadership conference. It is a retreat for outstanding youth to further develop their leadership skills. Sponsored by the 58 Rotary Clubs in Distinct 5330 (San Bernardino & Riverside counties), PRYDE combines training in a casual, relaxed atmosphere with social and fun time to provide a fast-paced and memorable leadership experience.

WHEN AND WHERE IS PRYDE?

PRYDE 2014 will be held Saturday May 17, through Sunday, May 18, 2014, at the beautiful Thousand Pines Camp and Conference Center in Crestline, California. The students will report to a designated bus pickup location on Saturday morning, May 17 for the first session. They will return Sunday afternoon, May 18. Exact details will be sent in a letter to all chosen participants. All PRYDE participants must arrive and depart on the official buses. There are no exceptions.

HOW MANY WILL ATTEND PRYDE?

Approximately 180 Seventh Grade students selected from all public and private schools within Rotary District 5330 will attend, along with 40 Rotarians and additional camp staff.

WHAT ARE THE CRITERIA FOR SELECTION?

Seventh grade students are selected by the local Rotary club on the basis of leadership potential, personal values, intelligence, and potential for future success. The participants must make a commitment to attend the whole weekend. They may not arrive late or leave early.

HOW ARE STUDENTS SELECTED?

The selection process may vary. Usually school staff members are asked to nominate seventh grade students. The sponsoring Rotary club appoints a screening committee to make the final selections.

WHAT TYPE OF ACTIVITIES ARE CONDUCTED AT THE CONFERENCE?

The program features several outstanding leadership speakers. These presentations are followed by discussions in small groups with trained adult discussion leaders. Recreation activities are scheduled throughout the weekend, including sports, games and a campfire. Excellent food and snacks are also provided.

HOW IS THE CONFERENCE SUPERVISED?

The conference is supervised by an all-volunteer Rotarian staff. The staff consists of 5 staff members, 20 discussion group leaders, 15 High School Interact students, and a camp nurse. Each discussion group leader is assigned to a group of 8 or 9 students for the entire weekend. Boys and girls are housed in separate dormitories with appropriate chaperones.

WHAT ARE THE COSTS TO THE PARTICIPANTS?

There is no direct cost to the participants. The sponsoring Rotary Clubs pay the fee for each camper that they send.

(PRYDE Form B)

Personal Rotary Youth Development Experience

May 17-18, 2014

Thousand Pines Camp, Crestline, California

Student Application

(Club selection process only)

Selection for this conference is based on the information given on this application and an oral interview.

Name

Address

Phone

SchoolGrade

Describe a situation that demonstrates your ability to set goals and accomplish them.

Describe who you want to be.

Describe how the PRYDE experience would be beneficial to you.

Describe how utilizing leadership or personal skills, has allowed you to make a difference.

(PRYDE Form C)

Personal Rotary Youth Development Experience

May 17-18, 2014

Thousand Pines Camp, Crestline, California

What to bring to camp:

_ Sleeping bag

_ Pillow

_ Blanket

_ Paper, pen, markers

_Camera

_ Flashlight

_ Toothbrush and toothpaste

_ Towels, washcloth, soap

_ Comb/brush

_ Medications, glasses

_ Sunglasses

_ Lip balm

_ Hand lotion

_ Cap/knit hat

_ Gloves

_ Non-slip shoes

_ Extra socks

_ Jacket/coat

_ Warm weather clothing

_ Cold weather clothing

In case of emergency, students may be contacted through:

Thousand Pines Camp and Conference Center

359 Thousand Pines Road, Crestline, CA. 92325-3288

909-338-2705 Phone

909-338-3511 Fax

Messages other than for emergencies will not be accepted.

(PRYDE Form D)

Personal Rotary Youth Development Experience

Rotary District 5330

May 17-18, 2014

PRYDE Registration

Please print legibly

Student’s Name______Sex Male______Female______

Home Address

Address ______City______Zip______

Mailing Address (if different from Home Address)

Address ______City______Zip______

Telephone ( )______

School______Age______School Grade______

Parent or Guardian’s Name______

Parent or Guardian’s Address______

Parent or Guardian’s Phone (Emergency Phone)(_ _ _)______

Sponsoring Rotary Club______

Students:Please return this Registration Form and the Release Form to your sponsoring Rotary Club before March 1, 2014

Do not write below this line

Bus #______

Cabin #______

Group______

(PRYDE Form E)

Medical & Liability Release Form (PRYDE Form F)

PRYDE May 17-18, 2014

(Must be completed for all Campers)

Please Print

Student’s Name ______Phone ( ) ______

Address ______City______Zip ______

Emergency Contact ______Phone ( ) ______

Health Questionnaire

If YES to any question please provide details/information on the reverse side of this form:

Yes / NoYes / No Yes / No

Allergies: ______Heart Condition ______Condition Restricting Activities: ______

Diabetes: ______Behavior Disorder: ______Physical Accommodations: ______

Asthma: ______Bleeding Condition: ______(wheel chair, Interpreter etc.)

Epilepsy: ______Migraine Headaches: ______Stomach Problems: ______

Menstrual Problems: ______Tetanus Current: ______

In the past 3 wks has your child been exposed to any infectious disease: ______

List all medications. All medication MUST be given to the camp nurse to be dispensed.

Medication Name / Dosage / Frequency

I give the health care provider(s) at Thousand Pines permission to give over the counter medication and administer other treatment, as they deem necessary. Any exceptions please explain on the reverse side of this form.

Medical Insurance Provider______Policy Number ______

Insured’s Name______

Please complete if you do not have a medical insurance carrier.

I give my permission to use my credit card in the event I have no insurance carrier.

Credit Card: _____Visa _____MasterCard Credit Card #______Exp______

Authorized Signature______

Medical Transportation, Activity and Photo Release

I give permission to Rotary District 5330, Thousand Pines and its agents to select transportation to a medical provider who may provide proper treatment for, hospitalization of, order injections, X-ray examinations, anesthesia or surgery for my child as named above. The above named agent is authorized to make medical decisions concerning the health and welfare of my child.

There are many inherent risks in a mountain camp experience. Camp activities include, but not limited to hiking, sports, games, low adventure ropes course, rock climbing and dancing. There is the possibility of risk of physical injury or harm from participating in these activities. I voluntarily elect to allow the above named to participate in activities and assume the risk of injury or harm that could result from participation. On my own behalf and that of my personal representatives and heirs, I hereby release Rotary District 5330, Thousand Pines, its officers, employees and agents from all liability from any injury or harm to my child (or minor) from participating in any activity at Thousand Pines Camp, whether the injury or harm is caused by accident or by negligence of Thousand Pines or otherwise.

I hereby agree that Rotary District 5330 or Thousand Pines may use any type of audio and/or visual records of this program for its promotional and/or commercial purposes without compensation to me.

Personal Rotary Youth Development Experience

Code of Conduct

You have been selected for this Personal Rotary Youth Development Experience because you have potential to be a leader. This camp will enhance your personal abilities, and offer you the opportunity to meet and share ideas with other leaders. Our speakers, activities, and discussion groups will provide you with many positive and helpful approaches to personal growth.