H.O.P.E. Leaders Application

Student Information

Name

Birth date

Gender

Male Female Prefer not to say

Which races or ethnicities best describe you?

White/ Caucasian Black/ African American Hispanic/ Latino Native American Asian/ Pacific Islander Other Prefer not to say

Please list any of the following: current medications, medication allergies, food allergies, or chronic health conditions.

T- Shirt Size

Social Media Handle(s)

I am on Soonercare:

Yes No Unsure

Contact

This address will receive a confirmation email

Phone

Address

Education

Grade

Other:

Parent/ Guardian Information

Parent/ Guardian Name

Parent/ Guardian Relation to You

Parent/ Guardian Primary Phone

Parent/ Guardian Address (If different from student's)

2nd Parent/ Guardian Name (If applicable)

2nd Parent/ Guardian Number (If applicable)

Who lives in your household?

Parent/ Guardian Liability Release: I am aware that during participation in activities at the Rose Bowl certain risks and danger may occur. These include, but may not be limited to, the hazards of being in an urban area, the force of nature, and other reasons because of the content of some of the ministries and activities. One Hope will take all reasonable precautions to ensure the safety of participants, but injuries, heat stroke, asthma, allergic reactions, etc, can occur in the normal course of games and sports. In consideration of these ministries and activities, I do hereby assume all risks and will hold One Hope and the employees/leadership/staff harmless from any and all liability, actions, cause of action, debts, claims, and demands of every kind and nature whatsoever which I now have or which may arise from or in connection with my participation in any activities arranged for me by One Hope or occurring at the Rose Bowl. The terms hereof shall serve as a RELEASE AND ASSUMPTION OF RISK for my heirs, executors, and administrators, and for all members of my family. In case of accident or illness, One Hope will attempt to provide first aid and arrange transportation to medical services if needed. I give them permission to authorize medical services or transportation as needed. Cost of medical care beyond first aid is the financial responsibility of the ill or injured person. I assume full responsibility for my health and my child's being such that the activities will in no way aggravate any conditions present. I declare the statements on this form to be true. I also agree that I will follow One Hope policies. I also release all images, videos, quotes, and other media that includes or features of me and/or my child to be used by One Hope as they see fit.

Digital Signature of Parent/ Guardian:

Emergency Contact

Emergency Contact Name

Emergency Contact Relation to You

Emergency Contact Number

Getting to Know You

Have you had previous work experience?

Yes No

Please list where, when, and in what capacity you have previously worked:

Have you or any of your family members participated in One Hope programs before?

Yes No

Program(s):

Do you have any siblings who plan to attend the One Hope summer camp this summer? If so, please list their name and grade

In a video OR a written paragraph, please answer the questions below:

Tell us about yourself! What are you like? What are you into?

Describe a time you saw someone having a hard time and what you did about it.

What’s a weakness or area of your life you'd like to get better this summer?

Do you feel qualified to work with kids? Why or why not?

What do you think makes someone a good leader?

What makes you want to be a H.O.P.E. Leader this summer?

What are your future goals?

We just want to get to know you better, don't sweat how you sound!

Send your video to @onehopetulsa on Instagram or send a Google Drive link to jerushafunderburk@onehopetulsa.com

OR write written response here

Are you involved in any extracurricular activities (community, school, church, etc)?

Other (please share other interests you have here):

Are you interested in receiving a financial stipend this summer?

Yes, I want to receive the $ stipend. No, I just want the volunteer experience.

References

Please provide information for two references.
Your 1st reference should be an adult who is not related to you.
Your 2nd reference should be a peer (someone around your age) that is not related to you.

Reference #1 Name (First and Last)

Reference #2 Relationship (coach, teacher, etc.)

Reference #2 Phone or Email

Reference #2 Name (First and Last)

Reference #2 Relationship (Friend, classmate, teammate, etc.)

Reference #2 Phone

Program Details and Permissions

H.O.P.E. Leaders Summer Schedule:
May 27th - May 30th - Noon - 5 PM.
June 3rd - 6th - 9:45 AM - 3:30 PM. (Project 61 Sports & Arts Camp week)
June 9th - 12th - Noon - 5 PM.
June 16th - 18th (Juneteenth Holiday) - Noon - 5 PM.
June 23rd - 26th - Noon - 5 PM.
June 30th - July 3rd - Noon - 5 PM.
July 7th - 10th - Noon - 5 PM.
July 14th - 17th - Noon - 5 PM.
July 21st - 24th - Noon - 5 PM.
July 28th - 30th - TBD

H.O.P.E. Leaders will be allowed 2 excused absences. If a leader needs to be absent for more than 2 days, this must be discussed in advance with program leaders.

Are you available to participate for the full summer schedule?

Yes No Unsure

Are you involved in other summer activities (like team workouts, summer school, or jobs)? If yes, what and when?

Will you need help with transportation?

Yes No Unsure

Do you have permission to walk to and from the Rose Bowl?

Yes No

Permissions:

I have discussed this opportunity with my parent/guardian. I give permission for One Hope Tulsa to contact my parent/guardian. I recognize that the H.O.P.E. Leaders Internship is rooted in Christian faith and values. By applying, I commit to conducting myself in a way that supports One Hope Tulsa’s faith-based, community-focused, trauma-responsive mission and values. I understand a follow-up interview may be part of the selection process. I certify that all the information I have listed is true and correct. I understand that before I am accepted into the program, I must agree to the One Hope Code of Conduct and that failure to follow the code of conduct would be cause for termination. I submitted my video or written response

H.O.P.E. Leaders Application

Description

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