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LIFE Impression Impact Application 2014 .pdf



Original filename: LIFE Impression-Impact Application 2014.pdf
Author: Pamela

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Mentorship Program for Asian American Girls
Dear L.I.F.E. Candidate and Parents,
Thank you for your interest in the Miss Asian American Colorado L.I.F.E. mentorship program. L.I.F.E. is a one year,
once a month, workshop/mentorship program for Asian American girls, hosted by the 2010 Miss Asian American
Colorado, Pamela Yang and the 2014 Miss Unity, Lena Chhay.
This year, we will have two target age groups within the program. The “Impressions” group will encompass ages 11-13
(middle-school aged students) and the “Impact” group will encompass ages 14-16 (high-school aged students). There
will be several workshops for the girls to interact and engage in, while helping them to build character and confidence.
Workshops include fun and LIFE-long learning about Inner Beauty, Identity, Culture, Asian American Female Leaders,
Team-Building, Leadership, Friendship, Public Speaking, setting Personal Goals, and even Community Engagement.
The first full-day workshop will be held at the Daniels Fund, 101 Monroe Street, Denver, CO 80206, on Saturday,
August 23rd, 2014, from 10am-2pm. We ask that you drop off your child 15 minutes early for check in and return for
pick up at 2pm. Attached to this application are parking instructions. There is a fee of $10 to participate in this first
workshop, which goes towards brunch. Please make checks payable to Asian Avenue Magazine. Cash also accepted.
Parents or Guardians, please complete the consent form on page 4. Candidates will not be able to attend the full-day
workshop unless this form is signed by a parent or guardian. Once we have received the application, we will send you a
confirmation, and you will receive a handbook with rules and regulations and the workshop schedule.
In addition, we hope that your child will find the workshops and the mentorship rewarding. The goal for this service
project is for community outreach, in educating young Asian American girls the importance of leadership and
community involvement. We look forward to organizing more workshops that are beneficial and impactful, and
community service projects that will make these girls become stronger leaders, involved in school and extracurricular
activities, and become comfortable with public speaking. Each participant will be paired with a Big Sister (a former Miss
Asian American Colorado candidate), who will serve as mentors during and after the workshop.
Our hope is to foster a network for Asian American women of all ages, as we share similar experiences and challenges.
L.I.F.E. is an opportunity to exchange life lessons, support each other through struggles, and celebrate in our successes.
If you have any concerns or questions, please feel free to contact us. Inquiries concerning “Impressions” (ages 11-13) can
be directed towards Pamela Yang at 720.480.3053 or synamyne@gmail.com. Inquiries concerning “Impact” (ages 14-16)
can be directed towards Lena Chhay at 720.280.5662 or lenachhay93@gmail.com.
Thank you and all the best,
Pam Yang
Miss Asian American Colorado 2010
720.480.3053 | synamyne@gmail.com

Lena Chhay
Miss Unity 2014
720.280.5662 | lenachhay93@gmail.com
1

Application Deadline: Friday, August 1st, 2014

Candidate, please fill out the entire form and submit by application deadline date. Please make
checks payable to Asian Avenue Magazine. Application can be mailed to:
11047 E. 26th Ave.
Denver, CO 80238
or attached in email to synamyne@gmail.com. Thank you!
Application Deadline: Friday, August 1st, 2014
Candidate’s Name ________________________ Preferred Name _____________________
Date of Birth _____________________________ Ethnicity ___________________________
Home address ________________________________________________________________
Home phone

Cell phone__________________________

School Name _________________________________________________________________
School Address _______________________________________________________________

Emergency Contact Information
Name ______________________________ Relationship ______________________________
Phone

Email ___________________________________

Address

Allergies/Medication, please specify: _____________________________________________

2

Please include what qualities you look for in a Mentor/Big Sister:
1. ________________________________________________________
2. ________________________________________________________
3. ________________________________________________________
Interests and Hobbies:
1. ________________________________________________________
2. ________________________________________________________
3. ________________________________________________________
How would describe your personality (use 3 words):
1. ________________________________________________________
2. ________________________________________________________
3. ________________________________________________________

3

Consent Form
Must be completed and signed by Candidate and Parent/Guardian
I, ___________________________, have filled this form to the best of
(Print Candidate’s Name)
my ability and all the information that I have provide are accurate and true. I agree
that for any reasons that do not allow me to attend the L.I.F.E. full-day workshop, I
must contact the Miss Asian American Colorado Committee at 720.480.3053 or email
at synamyne@gmail.com, to cancel within 24 hours before the workshop date, and will
not receive a refund of the $10.00 participation fee.
I, ___________________________, give, ________________________
(Print Parent or Guardian Name)
(Print Candidate’s Name)
permission to attend the Miss Asian American Colorado L.I.F.E mentorship program;
a full-day workshop on Saturday, August 23rd, 2014, at the Daniels Fund from 10am2pm. I take full responsibility for dropping off my child and picking up my child at the
set times that are given to me in this application packet.
I understand that if my child cannot attend or misses the full-day workshop, I must
inform the committee within 24 hours before the set date at 720.480.3053 or at
synamyne@gmail.com, and will not be receiving a refund of the $10.00 fee.
Candidate Signature______________________________ Date
Parent or Guardian Signature

Date

4

Map and Driving Directions:
Daniels Fund is located on the corner of 1st Avenue and Monroe Street. The address is:
Daniels Fund
101 Monroe Street, Denver, Colorado 80206
The parking lot is located at 1st and Madison, immediately west of the Daniels Fund building. The
parking lot is free and no code is needed to enter. The gate will rise as you drive up.
Handicap parking is also available in the underground parking lot at the Daniels Fund. If needed,
please notify the Operations Associate prior to your event. The Daniels Fund is residentially
located so please be considerate of the neighborhood and park only in our parking lot or on nonresidential streets.
Parking is free for meeting space guests. Accessible parking is available upon request.

5


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