Click here for a printable version of this application

1. I am interested in participating in the 3 STEP Mentoring Project as a: Click here to select Mentor Trainer (please note: all 3 phases of training will be required to participate in this level of the project) Mentor (only one training) Mentee (only one training)

2. I interpret in (city)
State: Click here to select AL GA KY MS NC SC TN VA WV
NOTE: Only applicants who work as interpreters in the following states are eligible to participate in this project: Alabama, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee, Virginia, West Virginia.

3. From the options below, please select which training you would like to attend. Mentor Trainers must select an option in each Phase. Mentors & Mentees select only one location in one Phase.

Phase I: August 24-25, 2007, in Wilson, NC Sept. 14-15, 2007, in Richmond, KY Oct. 12-13, 2007, in Jackson, MS
Phase II: February 28 - March 1, 2008, in Chattanooga, TN March 13-15, 2008, in Morgantown, WV April 10-12, 2008, in Birmingham, AL
Phase III: August 21-23, 2008, in Spartanburg, SC Sep 18-20, 2008, in Hampton, VA Oct 30 - Nov 1, 2008, in Atlanta, GA
NOTE: Training schedule is subject to change. Any changes will be communicated immediately.

4. The 3 STEP Mentoring Project has defined the target population as being someone who
   1) Resides and/or interprets in an area that is traditionally underserved AND/OR
   2) Belongs to a group that is traditionally underrepresented.
Please provide an explanation of how you feel you meet either or both criteria:

5. Please tell us a little bit about you professionally (e.g., prospective mentors provide an explanation of how long in the field, certifications, previous trainings, etc., and prospective mentees provide an explanation of your work experience as an interpreter, training both pre- and in-service, etc.):

6. Please tell us why we should select you for participation in the 3 STEP Mentoring Project:

7. Please describe any accommodations you might need in order to fully participate in the training:

8. Any other information you would like to provide to help us with our selection:

Please provide us with a recommendation from one person who is also representative of an underrepresented group or resides or works in an area that is underserved. This person should have a vested interest in your involvement in the Mentoring Project (consumer, agency, business hiring interpreters, etc.) and be able to provide information related to your commitment to the field. Please have them send their recommendation letter via email to 3-STEP@signs-of-development.org with your name in the subject line or mail it to:

Lynne Wiesman
3 STEP Mentoring Project Coordinator
Signs of Development
PO Box 4850
Lago Vista, TX 78645

Letters of recommendation and applications must be received not later than four weeks prior to training to be considered for participation in this project. Mentor and Mentee selections for Phase I will be made the first week in August.

Please provide us with your contact information:

Name:
Email:
Address:
Phone number:
Videophone:

Part of the goal of this project is to gather ongoing information on effective mentoring training and mentoring practices. Participants will be asked to sign a consent form allowing research to be conducted, which may include the filming of the training, the use of pre- and post-surveys and evaluations, follow-up individual or group interviews, and the future use of any filmed mentoring sessions. Participation in this research is voluntary and confidential.

By submitting this application for participation in the 3 STEP Mentoring Project, I understand that I am committing to participation in training and at least 6 months of post-training mentoring, support, and discussion with other Mentors, Mentor Trainers, and Project Trainers.

Participation in this project requires a fully refundable deposit of $150.00 that will be held (not deposited or cashed) and returned upon successful completion. The following are the criteria for successful completion for each group of participants:

• Mentor Trainer - I understand that I am committing to participating in all 3 phases of training and the 6 months post-training mentoring, support, discussion with Project Trainers after each training Phase, and completion of all requested evaluations and reports. Travel stipends will be provided upon successful completion of the project.
• Mentor - I understand that I am committing to 2 days of training and 6 months post-training mentoring of my assigned Mentees, discussion with other mentors and the Project Trainers, and completion of all requested evaluations and reports. Travel stipends may be available upon successful completion of the training and six months of post-training involvement.
• Mentee - I understand that I am committing to one day of training and six-months of mentoring with my assigned mentor. Successful completion is defined by participation in the one day training, development of a skill activity plan, at least 2 hours per week spent on skill development activity and journaling, being available to meet with the mentor at least once every three weeks, and completion of all requested evaluations and reports.

Please type your name and email address here signifying your understanding and acceptance of the statement above and attesting to the accuracy of the information submitted:
Name:
Email:
Participant Category: Click here to select: Mentor Trainer Mentor Mentee