MENTOR MANOR Connecting Hearts & Minds
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- María Mercedes Correa Campos
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1 Referral Criteria MENTOR MANOR Connecting Hearts & Minds Qualifying Students: Mentor Manor is designed for MISD students in grades 2nd-12th. Referral Concerns: Students needing extra academic support, experiencing selfesteem issues and/or difficulty forming positive relationships with peers or staff. Students experiencing family issues such as divorced families, single family homes, incarcerated or deported parents and/or students living in extreme poverty, are also good referral candidates. Who is Not a Good Candidate? Students who have multiple documented referrals on aggressive behaviors and chronic absenteeism may not be a good match for Mentor Manor. Please remember that many of our mentors are not trained on how to deal with students with complex behavioral issues. They are meant to be strong and positive role models in the lives of our students. If students are chronically absent, mentors will have a difficult time establishing the relationship. If you have a student that does not meet the criteria, but whom you feel would benefit from Mentor Manor, please reach out the Mentor Coordinator to discuss in more detail. We want all students to feel supported and valued! Mayra A. Hernandez, LCSW, SEP Mentor Manor Coordinator mayra.hernandez@manorisd.net
2 Mentor Manor Referral Form Date: Student Name: ID: Grade: Age: School: Parent Name: Parent Primary Phone Number: Parent Primary Language: The student is being referred for assistance in the following areas (check all that apply): Academic Issues Behavioral Issues Peer Relationships Self-Esteem Study Habits Social Skills Family Issues Special Needs Attitude Your Campus Mentor Program Point of Contact Information: Name: Phone Number: Referral Contact Information: Referred By (Name): Phone Number:
3 Other concerns for student, please specify: Why do you feel this youth would benefit from a mentor? What are his/her interests in and out of school? On a scale of 1-10 (10 being the best) how would you rate this student? Academic performance Social Skills Self-esteem Family support Communication skills Attitude about school/education Peer relationships
4 What subjects, if any, does the student need assistance with? Additional comments: Thank you for your recommendation Mentoring Program Coordinator Mayra A. Hernandez, LCSW, SEP Office Cell
5 MENTOR MANOR Conectando Corazones & Mentes Estudiantes cualificados: Mentor Manor está diseñado para estudiantes de MISD en los grados del 2 al 12. Preocupaciones de Referencia: Estudiantes que necesitan apoyo académico adicional, experimentan problemas de autoestima y / o dificultad para formar relaciones positivas con sus compañeros o el personal. Los estudiantes que experimentan problemas familiares como familias divorciadas, hogares unifamiliares, padres encarcelados o deportados y / o estudiantes que viven en extrema pobreza, también son buenos candidatos para referir. Quién no es un buen candidato? Los estudiantes que tienen múltiples referencias documentadas sobre comportamientos agresivos y ausentismo crónico pueden no ser un buen partido para Mentor Manor. Recuerde que muchos de nuestros mentores no están capacitados para tratar con estudiantes con problemas de comportamiento complejos. Están destinados a ser modelos positivos en la vida de nuestros estudiantes. Si los estudiantes están crónicamente ausentes, los mentores tendrán dificultades para establecer esa relación. Si usted tiene un estudiante que no cumple con los criterios, pero que usted cree que se beneficiaría de Mentor Manor, por favor póngase en contacto con el Coordinador de Mentores para discutirlo con más detalle. Queremos que todos los estudiantes se sientan apoyados y valorados! Mayra A. Hernandez, LCSW, SEP Mentor Manor Coordinator mayra.hernandez@manorisd.net
6 Formulario de Referencia a Mentor Manor Fecha: Nombre del Alumno: ID: Grado: Edad: Escuela: Nombre del Padre: Idioma de los Padres: Teléfono de los Padres: El estudiante está siendo referido para asistencia en las siguientes áreas (marque todas las que apliquen): Problemas Académicos Problemas de Comportamiento Relaciones con sus compañeros Auto-estima Hábitos de Estudio Destrezas Sociales Problemas Familiares Necesidades Especiales Actitud Información de Contacto del Mentor de su Escuela Nombre: Teléfono: Correo Electrónico: Información de Contacto de la Referencia: Referido por: Teléfono: Correo Electrónico:
7 Otras preocupaciones del estudiante, por favor especifique: Por qué sientes que este joven se beneficiaría de un mentor? Cuáles son sus intereses dentro y fuera de la escuela? En una escala de 1-10 (10 siendo la mejor) cómo calificaría a este estudiante? Desempeño académico Destrezas sociales Autoestima Apoyo familiar Habilidad para comunicarse Actitud sobre la escuela / la educación Relaciones con sus compañeros
8 Con qué clases, si las hay, necesita ayuda el estudiante? Comentarios adicionales: Gracias por su recomendación Coordinadora del Programa de Mentores Mayra A. Hernandez, LCSW, SEP Office Cell
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