GEM’s Prosper Facilitator Application Form

We are so honored you have expressed interest in joining our family of GEM facilitators! We are passionate about equipping our girls with the skills they need to thrive, be healthy, be empowered, and be confident.

If you have any questions or need additional information please feel free to contact Geneva Perry our Executive Director and Training Coordinator at (951) 257-8023 or geneva@gemwithin.org

FAQ about GEM

The cost of GEM Prosper Facilitator Training (virtual) is $350 per person. This is a one time training fee. We ask everyone to complete an online recertification process every two years. The cost is around $50.

GEM Program Fee To ensure the efficacy of your program and implementation outcomes there is a $185 per girl implementation fee. *

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Tell Us About You *

First

Last

What is your job title/position? *

What is your work email address? *

Entity Site Phone Number

Please insert email address for G.E.M. Facilitator Aspirant, if they are not completing this application themselves

Please insert phone number for G.E.M. Facilitator Aspirant, if they are not completing the application themselves

Please share your site's address *we will be mailing your training packages and all other materials to this address* *

What is your preferred shirt size (unisex sizing)? *

Tell us about your school district What is the name of your school district? *

What is your Superintendent name? Superintendent email? District address? *

Tell us about your school? What is the name of the school or agency where you plan to run GEM’s Gather? *

My school is a.. *

My school is a ______ school *

What is the name of your principal/adminstrator? *

What is the email of your principal/administrator? *

Please select the cultural demographic population of students that you service most *

Please select the demographic population of students that you service the most: *

Please select the average GPA for the girls who would be selected to participate in G.E.M. Gather Group *

What is the % of students at your school who receives free/reduced lunch? *

How did you learn about GEM? *

GEM is a professionally delivered program. Therefore we require each applicant to hold a state issued or degree license in education, social work, psychology, or counseling. Please indicate the license you hold. *

Share with us your experiences running small group programming/counseling sessions *

How long have you been in the field of counseling and/or education? *

When do you plan to start your GEM Gather program and how often will you meet with your group? *

Please select which possible date you may want to complete your GEM Prosper Facilitator Training. Full participation and attendance is required to earn licensure of curriculum. *

If applicable my training invoice should be sent to: (please include full name and email) *

I am familiar with my school policies and procedures for identifying and reporting child physical abuse, sexual abuse, sexual harrassment and neglect. (Select option: Yes or No) *

What are your ideas/plans around funding your GEM program? (ex: title I, my department budget at school, Title IV or other SEL funding, my principal/district is committed to supporting, grant funding, etc.) *