The Michael Perelstein Memorial Scholarship Fund Discover Your Passion Competition. Presented in collaboration with APPLICATION

Transcription

1 The Michael Perelstein Memorial Scholarship Fund Discover Your Passion Competition Presented in collaboration with APPLICATION To qualify, please send the following items on the checklist below to OR mail to: The School Choice Group Discover Your Passion Competition 150 Grand St., 5th floor White Plains, New York Discover Your Passion Checklist: Application [includes essay, signatures, use of funds, parental consent in the following pages] Nominating Letter from Parent, Guardian or Adult familiar with my talent Download the Form Nominating Letter from Teacher, Counselor, Instructor, or other relevant authority familiar with my talent Download the Form Submission in one or more of the following Submission Formats: TEXT [writing samples, poetry, and all other text-based bodies of work] AUDIO [musical performance and all other audio-based presentations of work but may not exceed 5 minutes in length. This shall serve as a sampling for longer form works.] VIDEO [A link to a YouTube video is preferred, though should not exceed 5 minutes in length. This should serve as a sample of the work if the actual work is beyond 5 minutes in length. Please share the link below.] PHOTO [This may include photographs or other works best represented through photo submission.] If you are submitting files that are uploaded online via YouTube or another website, please list the links below: PAGE 1

2 TO BE COMPLETED BY PARENT OR GUARDIAN PARENTS: Please fill out the following form accurately, then OR mail to: The School Choice Group, Discover Your Passion Competition, 150 Grand St., 5th floor, White Plains, New York To ensure compliance with the Children s Online Privacy Protection Act of 1998, or COPPA, parental/guardian consent is required for your child to apply for the Discover Your Passion Scholarship Competition. However, Part Two of the application should incorporate only your child s words and explanations. PART 1: Applicant Information/ Parental Consent Parent/Guardian Name- Last Name First Name Middle Address Home Address Apt No. City State Zip Country Phone Mobile Phone State of Drivers License Issuance Last 4 Digits of Social *THIS INFORMATION IS USED TO COMPLY WITH COPPA REGULATIONS ONLY AND WILL NOT BE USED FOR ANY OTHER PURPOSE. INITIAL HERE If you are unable or unwilling to provide the information above. If your child s submission is accepted as a FINALIST, a phone interview may satisfy parental consent. Format of Submission(s) TEXT AUDIO VIDEO PHOTO PAGE 2

3 Child s Name- Last Name First Name Middle Gender M F (PLEASE CHOOSE ONE) Current School Category: Grade 2-5 Grade 6-8 Grade 9-12 *PLEASE CIRCLE GRADE WHEN WORK WAS COMPLETED. (FOR EXAMPLE, CIRCLE GRADE 6-8 FOR A CURRENT 9TH GRADER WHO COMPLETED THE WORK IN 8TH GRADE.) Address Grade in School Years of Practice/Study Name of Current Teacher/Mentor Contact phone or I Affirm That: I am the parent or guardian of a child who is, or was, a NYC student in 2nd through 12th grade at a public, private, charter school or an NYC homeschooler when work was completed. The work submitted was completed during 2016 or 2017 I have read and understand the terms and conditions * PARENT or GUARDIAN SIGNATURE PRINT NAME DATE CHILD SIGNATURE PRINT NAME DATE DISCLAIMER: By applying, applicant implicitly provides permission to use projects and submitted work on P.A.L, NYC G&T Symposium and School Choice International websites, PR activities including YouTube, blog, social media outlets and in press-related materials. Applicant, nor their immediate family members can be an employee, service provider, relative or client of SCI, PAL, or conference personnel. PAGE 3

4 JUDGING CRITERIA: The criteria for judging entries is: 30% quality, process and scope of entry (projects will be judged as much by the process as by the finished product); 30% originality & creativity; 30% depth of knowledge/apparent passion for domain mastery; 10% use of funds to achieve desired goal. PART ONE: Please answer the following questions. The Essay: Describe Your Passion and Why You Submitted the Work Consider why and how the work was pursued; challenges, if any, the process and why this particular work is significant. PAGE 4

5 What inspired you to pursue this passion or interest area? Why is this project worthy of scholarship money? How does it support your dream or goals toward your passion area? PAGE 5

6 Why did you choose this type of work to express yourself. In other words, what medium did you choose and why? (writing, music, app development, instrument, performance, presentation, other-please explain)? How much time (hours/days/months) did it take you to complete the work submitted, or how much practice was necessary in order to create the work submitted? Where was the work completed and when? Who supervised or helped you with your work, if anyone? Explain and provide names, titles, , and phone numbers. PAGE 6

7 PART TWO: Parent/Guardian Perspective- to be completed by parent or guardian PARENT/GUARDIAN: Please IDENTIFY any family or work-related issues which may prevent or interfere with your child s ability to pursue their passion. PARENT/GUARDIAN: Please share your perspective about your child s passion- when you first noticed it; why you think it warrants scholarship funding, and how you intend to support your child s passion. PAGE 7

8 PART THREE: Funding- may be completed with parent or guardian assistance If you become an Awardee (winner), how do you intend to use the award money of up to $5000? Please explain how money would be used, as well as how that opportunity (a class, a summer camp, an instrument, a tutor, etc) would benefit you and your passion. Please provide a BUDGET below that details the service or product and its COST to validate use of the award monies. If you are not sure about price, do some research to get a good sense of the numbers. Budget Template: Service or Product Cost Duration/Length of Service Provider of Service Example: Private Piano Lessons $500/16 weeks Super Music School PAGE 8

9 Please provide a Written Description that details how the service or product will support your Pursuit of Your Passion. Ready to submit your application? To qualify, please make sure to send all of the items on the checklist to Discoveryourpassion@schoolchoiceintl.com OR mail to: The School Choice Group Discover Your Passion Competition 150 Grand St., 5th floor White Plains, New York To review the Terms and Conditions, please read the next page. PAGE 9

10 Terms and Conditions IF YOU ARE UNDER 13 YEARS OF AGE, YOU MUST HAVE PARENT PERMISSION TO USE THIS WEBSITE Please see the Children s Online Privacy Protection Act of 1998 for more information. USE OF THE WEB SITE IS SUBJECT TO THE FOLLOWING TERMS AND CONDITIONS (COLLECTIVELY REFERRED TO HEREIN AS THE TERMS ). USING THE WEB SITE CONSTITUTES YOUR ACCEPTANCE OF THESE TERMS. THE P.A.L. WORKSHOPS & SCHOOL CHOICE INTL. MAY REVISE THESE TERMS, INCLUDING THE PRIVACY POLICY, AT ANY TIME WITH OR WITHOUT NOTICE BY POSTING THE REVISED TERMS ON THE SITE. Introduction Through its web site at (the Site ), as well as sister sites that mirror the content, the P.A.L. Workshops in partnership with School Choice Intl. provides information and the opportunity to apply to the Discover Your Passion Competition. The term you or User as used herein refers to any person or entity accessing the Site for any reason. No Warranty THE SITE IS PROVIDED AS IS WITHOUT WARRANTY OF ANY KIND, EXPRESS OR IMPLIED, INCLUDING, WITHOUT LIMITATION, ANY IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE OR NON-INFRINGEMENT. SPECIFICALLY, THE P.A.L. WORKSHOPS & SCHOOL CHOICE INTL. DOES NOT WARRANT THAT YOU WILL HAVE ACCESS AT ALL TIMES TO THE SITE AND THAT THE SITE WILL MEET YOUR REQUIREMENTS OR THAT THE OPERATION OF THE SITE WILL BE UNINTERRUPTED OR ERROR-FREE. FURTHER, THE PAL WORKSHOPS & SCHOOL CHOICE INTL. MAKES NO WARRANTIES AS TO YOUR ACCEPTANCE IN THE COMPETITION BASED UPON THE INFORMATION YOU PROVIDE ON THE SITE. Equal Opportunity The P.A.L. Workshops & School Choice Intl. are committed to a policy of equal treatment and opportunity in every aspect of its relations with its staff members, without regard to age, citizenship status, color, disability, marital or parental status, national origin, race, religion, sex, or sexual orientation. Proprietary Rights in the Site All content on the Site and any and all associated, copyrights, trademarks and other intellectual property rights related thereto are the sole and exclusive property of the P.A.L. Workshops & School Choice Intl, and its affiliates or licensors. You shall not duplicate, modify, copy, or post any part of the Site or the Site s content in any form or by any means, in whole or in part, without the P.A.L. Workshops & School Choice Intl. prior written permission. Third Party Websites and Content The Site may contain links to other web sites ( Third Party Sites ) as well as articles, photographs, text, graphics, pictures, video, information and other content or items belonging to or originating from third parties (the Third Party Material ). The P.A.L. Workshops & School Choice Intl. shall not be responsible for monitoring or checking for accuracy such Third Party Sites and Third Party Material, or access to these Third Party Sites and Third Party Material posted on, available through or installed from the Site. Inclusion of, linking to or permitting the use or installation of any Third Party Site or any Third Party Material does not imply approval or endorsement by the P.A.L. Workshops & School Choice Intl. Users shall be solely responsible should Users wish to leave the Site and access Third Party Sites or to use or rely on any Third Party Material. Governing Law By visiting or using the Site, you agree that the laws of the State of New York, without regard to principles of conflict of laws, will govern these Terms and any dispute of any sort that might arise between you and the P.A.L. Workshops & School Choice Intl. or any of its affiliates. With respect to any disputes or claims, you agree not to commence or prosecute any action in connection therewith other than in the state and federal courts of New York, and you hereby consent to, and waive all defenses of lack of personal jurisdiction and forum non conveniens with respect to, venue and jurisdiction in the state and federal courts of New York. Discover Your Passion REGISTRATION Registration Certain users may visit the Site to apply to participate in the Discover Your Passion Competition. By visiting the Site and accepting these Terms, you represent and warrant to the P.A.L. Workshops & School Choice Intl. that all of the information you supply to the Site is true and correct. You further give the P.A.L. Workshops & School Choice Intl. and its affiliates your consent to verify, by whatever means necessary, the information you provide. You also represent and warrant that you will use the Site in a manner consistent with any and all applicable laws and regulations. During the application process, you may be asked to provide certain personal information. You may also be asked to provide supporting documentation. You are required to provide accurate, complete and current information about yourself in all required fields. Should any such information change after submitting it to the Site, you are required to update that information as soon as possible. Any application with incorrect or incomplete information will not be processed by the Site. Information you submit will be used in accordance with the Privacy Policy. Minimum Age to Apply You represent that you are at least thirteen (13) years of age OR have a parent or guardian s permission to apply for the Discover Your Passion Competition. LIMITATION OF LIABILITY TO THE MAXIMUM EXTENT PERMITTED BY APPLICABLE LAW, IN NO EVENT SHALL THE P.A.L.WORKSHOPS & SCHOOL CHOICE INTL. BE LIABLE FOR ANY SPECIAL, INCIDENTAL, INDIRECT, OR CONSEQUENTIAL DAMAGES WHATSOEVER (INCLUDING, WITHOUT LIMITATION, DAMAGES RELATED TO NON-ACCEPTANCE TO THE Discover Your Passion COMPETITION) ARISING FROM THE RELIANCE ON, THE USE OF OR INABILITY TO USE THIS SITE. THIS LIMITATION APPLIES EVEN IF THE PAL WORKSHOPS & SCHOOL CHOICE INTL. HAVE BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. OTHER These Terms constitute the entire agreement between you and the P.A.L. Workshops & School Choice Intl. regarding the use of the Site. The failure of the P.A.L. Workshops & School Choice Intl. or any of its partners or affiliates to exercise or enforce any right or provision of these Terms shall not constitute a waiver of such right or provision in that or any other instance. If any provision of these Terms is held invalid, the remainder of these Terms shall continue in full force and effect. If any provision of these Terms shall be deemed unlawful, void or for any reason unenforceable, then that provision shall be deemed severable from these Terms and shall not affect the validity and enforceability of any remaining provisions. CONTACT Should you require any further information related to the Site and/or these Terms, please contact the P.A.L. Workshops or School Choice Intl. at: The P.A.L. Workshops Phone: Facsimile: palworkshops@me.com School Choice Intl. Address: 150 Grand St, 5th Floor, White Plains, New York, Phone: Facsimile: info@schoolchoiceintl.com 2017 Discover Your Passion - Official Site - PAL Workshops/School Choice Intl., All Rights Reserved. PAGE 10