2015 UPD Host Teen/Family Application
Dear Applicant:
Thank you for your interest in becoming a host teen & host family in our 2015 UPD (Ulster Project
Delaware) program. Every adventure begins with a first step. Your first step begins with completion and
submission of your written application. Please read the information and follow the instructions below, paying
particular attention to important dates.
The Ulster Project Delaware 2015 Application consists of 5 parts:
1. Code of Conduct/Signatures Page
2. Teen Application section (typed)
3. Parent/Guardian Application section (typed)
4. Teen Essay (completed by teen only) Minimum 1 double-spaced page
5. Letter of reference from a teacher, youth group leader, etc.
Application submissions are being accepted ASAP!
All s e c t i o n s of the application (except the signatures page) must be completed and forwarded electronically.
There is a required host teen and family interview.
Letters of acceptance will be emailed.
E-mail
completed
application
and
[email protected].
reference
Teens and parents will be asked to sign the signatures page during their home interview.
Sincerely,
Therese Moore 302.275.75.98
Bud Keegan 302.743.0626
Host Recruitment Co-Chairs
Ulster Project Delaware
Family Code of
Conduct
letter
to
The Board of Directors of Ulster Project Delaware believes that the regulations outlined below are
necessary for the safety and protection of the Northern Irish teens, the American host family and the
Project as a whole. Any violation of these regulations will be reviewed by the Executive Committee
of the UPD Board and may result in the immediate removal of the Northern Irish teen or the
American Family from the project.
1. Any use of drugs is prohibited and will not be tolerated.
2. No UPD teen participant is permitted to drink alcoholic beverages during the Project.
Remember, it is illegal for anyone under twenty-one to drink.
3. All UPD summer events, including orientation for host families and teen parties, will be
alcohol free.
4. All teen parties must be adequately and responsibly chaperoned and end at a reasonable time.
5. No one under the age of 18 will be allowed to drive a motor vehicle whil e a Northern Irish
teen is a passenger.
6. Northern Irish teens are not allowed to drive a motor vehicle.
We have read the above regulations and agree to abide by them. We also agree that any infraction
of the aforementioned regulations may result in the immediate termination of our participation in
the project.
Signatures Page - UPD 2015
By signing this application, you are agreeing to the following:
1) The host teen applicant has completed this application on his or her own personal honesty.
2) The host parents/guardians have completed this application honestly.
3) You consent to the Ulster Project Delaware Family Code of Conduct
4) The host teen applicant has completed the essay to the best of his or her ability.
Agreed and Accepted____________________________________
Parent/Guardian
Date:
_
Agreed and Accepted_____________________________________
Parent/Guardian
Date:
_
Agreed and Accepted____________________________________
Teen
Date:_______________
Please provide email addresses we should use during the application process. All communication
will be sent via email addresses you provide in this section.
_______________________________________________________________________________________
Teen Application
Name:
Address:
Phone Number: (Home):
Phone Number : (Cell):
Email Address:
Date of Birth:
Religious Denomination:
Church:
School:
Current Grade:
Tee Shirt Size: S M L XL
How did you hear about UPD?
Previous/current leadership experience:
Previous/current experience in religious groups/organizations:
Previous/current community service/volunteer experience:
Previous/current work experience:
Previous/current experience in athletics:
Previous/current experience in music/arts:
On a scale of 1-10 (1= least and 10 = most), how interested are you in participating in UPD? Why?
On a scale of 1-10 (1= least and 10 = most), how do you see yourself in the area of school work? Why?
On a scale of 1-10, (1= least and 10 = most), how do you see yourself in the area of social life? Why?
On a scale of 1-10 (1= least and 10 = most), how do you see yourself in the area of maturity? Why?
On a scale of 1-10 (1= least and 10 = most), how do you see yourself in the area of ability to get along in
a large group? Why?
Teen Essay
(Please complete on your own. Should be at least one page, double spaced)
1. If accepted to Ulster Project Delaware, what do you see as your contribution to the project?
2. What do you hope the project will do for you?
Parent/Guardian Application Section
Parent/Guardian 1 Name:
Parent/Guardian 1 Address:
Parent/Guardian 1 Home Phone:
Parent/Guardian 1 Cell Phone:
Parent/Guardian 1 Work Phone:
Parent/Guardian 1 Email Address:
Parent/Guardian 1 Employer:
Parent/Guardian 1 Religious Denomination:
Parent/Guardian 1 Church:
Parent/Guardian 2 Name:
Parent/Guardian 2 Address:
Parent/Guardian 2 Home Phone:
Parent/Guardian 2 Cell Phone:
Parent/Guardian 2 Work Phone:
Parent/Guardian 2 Email Address:
Parent/Guardian 2 Employer:
Parent/Guardian 2 Religious Denomination:
Parent/Guardian 2 Church:
List other children's names, dates of birth, sex and whether they will be living in the same household
during the project period (July 2015):
List number and types of pets in your home:
List any allergies, food or pet, your prospective host teen may have:
List any physical limitations your prospective host teen may have:
List any “real” fears your prospective host teen may have:
On a scale of 1-10 (1= least and 10 =most), how interested is your teen in participating in UPD? Why?
On a scale of 1-10 (1= least and 10 = most), how do you see your teen in the area of school work? Why?
On a scale of 1-10 (1= least and 10 = most), how do you see your teen in the area of social life? Why?
On a scale of 1-10 (1= least and 10 = most), how do you see your teen in the area of maturity? Why?
On a scale of 1-10 (1= least and 10 =most), how do you see your teen in the area of ability to get along in a
large group? Why?
Why does your family wish to participate in UPD?
If accepted, what will your teen contribute to the project?
If accepted, what will your family offer to the project?
If accepted, how will your teen benefit from the UPD experience?