Mindful Schools - School-Wide Implementation Application

Application for 2020-2021 School-Wide Implementation Program
Thank you for your interest in the Mindful Schools School-Wide Implementation Program! We are excited to learn more about your work and goals in through this application process.

We will be reviewing applications on a rolling basis. All applications received before November 15th will receive a response within four weeks of receipt of application. For applications received after November 15th, a response will be received within three weeks of receipt of application.

Please feel free to reach out to support@mindfulschools.org with questions.

Personal Information
Please use an email that is accessible to you year-round, and that you will check often. If you are accepted to the program you will be required to use the same email address for registration.
First Name*
Last Name*
Gender Pronouns*

He, him, hisShe, her, hersThey, them, theirsOther
Role*
EX: 3rd or 4th Grade PE Teacher, middle school guidance counsellor, therapist in private practice
Organization or Company*
Website
Phone Number*

Country CodeArea CodePhone Number
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Are you applying with anyone else?*
Please provide the name of anyone you're applying with.

Professional Background
Which of the following professional categories best describe your work?*

Personal Mindfulness Practice Experience
Describe how you came to mindfulness practice and how it has impacted your life. (In other words, why do you practice mindfulness, and how did you get started?)*

0/1200
Describe your practice in detail, including how often and for how long you practice on average? Please include experience with: Seated practice, mindful movement, in person practice groups, guided practices, apps, and recordings.*

0/800
Please list any courses you've taken in addition to Mindful Teacher Certification Program?*

0/800
Please list any retreat experience in addition to the MTCP retreat experience, or any one on one study or teachers with whom you have studied?

0/800
How many years have you had a daily mindfulness practice?*
How many days have you spent in silent retreats in addition to those spent in retreat as a part of the Mindful Teacher Certification Program?*

Experience Teaching Mindfulness
The Mindful Schools School-Wide Implementation Program is for those educators who are passionate about dedicating themselves to bringing mindfulness to a wider audience (such as a school, district, or organization). We ask that all applicants have a regular mindfulness practice and have completed the Mindful Teacher Certification Program. Please tell us when you completed the following courses, and any other relevant courses:
Mindful Teacher Certification Program (also known as “Year-Long Program”) (month/year completed)*

0/800
Other Mindful Schools Courses Completed*

0/800
Other Mindfulness Teacher Training Programs Completed? (list course name, organization, and year completed)

0/800
In what capacity do you teach mindfulness, and for how long?

0/1200
If applicable, in what capacity are you leading mindfulness initiatives in your contexts and for how long?

0/1200
If you already work on school-wide or district-wide mindfulness, in what capacity do you do this work, and for how long have you been doing this work?

0/1200

Your Interest in This Program
Please tell us about why you are applying for the Mindful Schools School-Wide Implementation Program. How will this program improve your ability to do the work you do (or plan to do) in your school community? How will it help you develop and grow as an educator, both personally and professionally? How will it enhance your capacity to be a force for positive change in our schools?*

0/1200
What gaps in your development as a Mindful Teacher are you hoping this program will support you with? What are some common challenges you've faced in school-wide implementation?*

0/1200
Optional: Is there anything else we should know about you that you haven't had the opportunity to tell us yet?

0/800

Demographic Information
Which category or categories best describe you?

American Indian or Alaska NativeAsianBlack or African AmericanHispanic, Latino, or Spanish OriginMiddle Eastern or North AfricanNative Hawaiian or Other Pacific IslanderWhiteOther
Do you identify as LGBTQ+?
Please indicate your age:
Please indicate the range that best represents your PERSONAL/HOUSEHOLD Income:
What is the highest degree or level of school you have completed? If currently enrolled, highest degree received.
Please share with us the languages you speak:

Scholarship Applicants
Mindful Schools is dedicated to making our trainings affordable to educators who would otherwise not be able to attend. We receive significantly more requests for financial aid than we can fulfill, so please take time to evaluate your need honestly and thoughtfully.

Criteria for Scholarship Applicants

Scholarship Application Deadline: February 1

In awarding scholarships, we prioritize the following:
- Applicants currently working in a paid capacity in public school or agency environments with high-risk and/or underserved populations.
- Applicants from underrepresented backgrounds and life experiences (including but not limited to: race, class, gender identity, and sexual orientation).
- Applicants with significant and demonstrable economic need.
Scholarship Tuition: $2,775 USD
- Recipients must be able to cover the cost of the scholarship tuition plus retreat lodging and travel.
- Scholarship recipients must commit to the entire program to be considered for this scholarship.
- Standard registration fee and payment plan guidelines apply to financial aid recipients.
- If needed, you may be contacted and asked to provide a letter of recommendation.
Are you applying for a scholarship?*

YesNo
Impact
Please describe the school or agency where you work and the youth population you serve. Please specifically note any marginalized populations with whom you work.

0/800
Please describe specifically how this training will help you to serve these students.

0/800
If you work with underserved youth populations (e.g. high poverty, LGBTQ+, racially marginalized) for how many years have you done so?
What percentage of the youth you serve are on Free/Reduced Lunch where you work? (If you do not work in a US public school that tracks this statistic, please indicate what percentage of the youth you serve is at or below the poverty line.)
Do you work at any of the following as a paid employee?

Title One School (federal designation for high poverty school)Government Service Agency or Non-Profit Service Agency (does not include public schools)School exclusively for students with disabilities requiring special support services.I do not work for any of the above
Financial Need
What is the annual household income for all wage earners in your home?*
How many people (including yourself) currently live in your household and are dependent on the above income?*
Are there any further details that would help us better understand your financial situation?

0/800
Please indicate any outside scholarships, professional development grants, or other funding that you have secured towards the cost of this program. (This will not be counted against you.)

0/800
Background
Mindful Schools prioritizes including educators and service providers from underrepresented backgrounds in this program (including but not limited to: race, class, gender identity, and sexual orientation). Is there anything you would like to share with us about your background that would help us to better understand your life experience?

0/800
Is there anything else we need to know to fairly evaluate your scholarship request?

0/800
Should be Empty:

Application for 2020-2021 School-Wide Implementation Program

Impact

Financial Need

Background