Scholarship Application - Prime Time Palm Beach County

Scholarship Application
Fax or email your scholarship application to Nicole Tarsia, Scholarship Coordinator.
Phone: 561-600-9527
Fax: 561-327-4882
Email: [email protected]
Submit scholarship applications at least 15 business days before the class, conference, or event start date. Late applications are not
considered. All scholarship applications are considered on a first come, first serve basis for Prime Time-approved classes, conferences,
and events. However, priority funding is given to applicants who have not previously been awarded a Prime Time Scholarship.
Eligibility: Management and frontline practitioners employed in a Palm Beach County afterschool program and working 15 or more hours
per week with school-age children.
Awards: Classes, conferences, and events promoting quality afterschool programming and management and directly related to the
afterschool field.
Career Advising: For more information on the approved coursework, and to receive individual education and career advising, contact Elisa
Moro, Career Advisor, at 561-600-9528 or [email protected].
Prime Time Scholarships Cover:
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Youth Development non-credit and credit coursework:
 An afterschool practitioner is eligible to receive a maximum of four scholarships per fiscal year* for college non-credit classes
and four scholarships per fiscal year* for credit classes.
 Scholarship awards given to applicants taking college classes will cover the full tuition amount for the approved class, as well
as the full cost of textbooks for the class.
 Prime Time scholarships do not cover out-of-state tuition.
Youth Development conferences, workshops, seminars, and events:
 An organization is eligible to send one afterschool practitioner to a conference or event per fiscal year.
 An afterschool practitioner is eligible to receive a maximum of one scholarship per fiscal year* to attend a conference or event.
 Scholarship awards for conferences and events will pay the registration fee for the approved event. The maximum award for
in-state events is $350.00 and the maximum award for out-of-state events is $450.00.
(*) Prime Time’s fiscal year begins October 1 and ends September 30 of the following year.
Next Steps:
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Complete the scholarship application.
If you are taking a Palm Beach State College class, submit your course schedule with your scholarship application. You may need to
update your Program Objective Code in order to register for the course.
If you are taking a FL Department of Children and Families (DCF) course, register for the course and submit your invoice with your
scholarship application.
If you are attending a conference or event, register for the event, request an invoice, and submit the invoice with your scholarship
application.
Submit your Palm Beach State College (PBSC) and/or FL Department of Children and Families (DCF) transcripts with your application, if
you are a first time applicant and have attended PBSC and/or DCF classes.
Print and fax your scholarship application to 561-327-4882 or scan and email it to [email protected]. Include your PBSC course
schedule, DCF invoice, and and/or conference/event registration form with your application.
For detailed instructions, go to www.primetimepbc.org – Career Advising –
Trailblazing the Pathways for Afterschool: The Route to Afterschool Professional Development.
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Registration instructions for Palm Beach State College courses
Instructions for updating your Palm Beach State College Program Objective Code (POC)
Registration instructions for FL Department of Children and Families (DCF) courses
Instructions for submitting your Palm Beach State College (PBSC) and/or FL Department of Children and Families (DCF) transcripts
Prime Time Palm Beach County, Inc. receives significant funding from the Children's Services Council of Palm Beach County.
2300 High Ridge Road, Suite 330 | Boynton Beach, FL 33426
Tel 561-732-8066 | Fax 561-732-8094 | www.primetimepbc.org
© 2014 Prime Time Palm Beach County, Inc. (Document last modified September 09, 2014)
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Scholarship Application
Fax or email your scholarship application to Nicole Tarsia, Scholarship Coordinator.
Phone: 561-600-9527
Fax: 561-327-4882
Email: [email protected]
Personal Information (Please Print Legibly)
First Name:
Gender: ☐ Male
Last Name:
☐ Female
□ Mr.
□ Mrs. □ Ms.
Date of Birth (MM/DD/YY):
□ Asian □ African American □ Caucasian □ Guatemalan Mayan
Racial/Ethnic Background (for demographic purposes only):
□ Haitian/Caribbean Islander □ Hispanic
□ Native American □ Other:
Home Phone:
Cell Phone:
Personal Email:
Employment Information
Name of Afterschool Program:
Employer’s Address:
City:
State: FL
Work Phone:
Zip:
Work Email:
Position Information
Start Date:
□ Less than 15 hours per week
□ Part Time (between 15 and
19 hours per week)
□ Full Time (20 or more hours per
week)
Primary Position - Frontline Staff (select one):
Primary Position - Upper Level Management (select one):
□ Counselor in Training
□ Certified Counselor
□ Program Coordinator
□ Director
□ Counselor
□ Activity Leader
□ Assistant Director
□ Executive Director
□ Other:
□ Other:
Grade of children you’re primarily working with - 15 hours or more per week (select one):
□ Elementary (K – 5th Grade)
□ Middle School (6th – 8th Grade)
□ High School (9th _ 12th Grade)
Please write a paragraph about why you chose to take the class, conference, workshop, or seminar you are
applying for a scholarship to attend. Include how you think it will help you in your job/career as an afterschool
professional (Your application will not be considered if this section is incomplete):
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Instructions: Please check the class, conference, and/or event you would like to attend. If you are taking a Palm
Beach State College class, submit your course schedule with your scholarship application. You may also need to
update your Palm Beach State College Program Objective Code (POC) based on the certificate/degree you would
like to obtain.
Youth Development Non-Credit/Certificate Courses:
Select coursework from this section if you are interested
in obtaining your 40-Hour School Age Certificate, the School Age Professional Certificate, the FL Staff Credential, and/or the
Director Credential. Individuals taking the School Age Professional Certificate must have their 40-Hr School Age Certification
and submit their DCF transcript and Foundations of Advancing Youth Development certificate (if applicable).
40-Hour School Age Certification (POC 5373)
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Course #
HEV0803
HEV0804
Course Name
Part 1 - School Age Program Certification (PSAV)
Part 2 - Foundations of Advancing Youth Development (AYD) Principles (PSAV)
School Age Professional Certificate (POC 5373):
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Course #
HEV0194
HEV0195
Course Name
School Age Professional Certificate Mod 1 (PSAV)
School Age Professional Certificate Mod 2 (PSAV)
Director Credential Level I Requirements: Child Care Center Management (POC 6366)
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Course #
HEV0123
EEC1523
Course Name
10-Hour Special Needs Appropriate Practices (PSAV)
Overview of Child Care Center Management (AS)
Director Credential Renewal, Level II, and Advanced Level Requirements: Child Care Center Management (POC 6366)
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Course #
EEC2002
EEC2202
EEC2521
Course Name
Child Care and Education Organization Leadership Management (AS)
Child Care and Education Programming (AS)
Child Care and Education Financial and Legal Issues (AS)
Other Palm Beach State College Courses
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Course #
HEO0106
HEV0198
EEC2271
N/A
Course Name
Child Care First Aid and CPR
10-Hour School Age Appropriate Practices (PSAV)
Teaching Children with Special Needs (AS)
Other Youth Development Coursework
Online DCF Courses
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Course #
FACR
HSAN
CAAN
SNP
Course Name
Child Care Facility Rules & Regulations
Health, Safety & Nutrition
Identifying & Reporting Child Abuse and Neglect
Special Needs Appropriate Practices
Conference or Event:
Complete this section if you are interested in attending a conference, workshop, or event that is
specific to the afterschool field. Register for the event and include your registration form along with the scholarship
application. Do not pay for the event in advance.
Conference/Event:
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Youth Development Credit Pathway Courses:
Select coursework from this section if you are interested in
obtaining your Youth Development College Credit Certificate (YDCCC), AS Degree in Human Services – Youth Development
Concentration, and/or BAS degree in Supervision and Management. You must complete the YDCCC before receiving
scholarships for AS degree coursework, and complete the AS degree before receiving scholarships for BAS degree
coursework. In addition, you must either complete or be taking the core YDCCC classes before receiving scholarships for
other YDCCC coursework. The core YDCCC classes are HUS1203, HUS1620, and HUS1640.
Youth Development College Credit Certificate (POC 6387)
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Course #
HUS1203
HUS1620
HUS1640
HUS1001
SYG2010
EDF1030
PSY2012
DEP2004
HUS1850
HUS1850L
Course Name
Principles of Group Facilitation (AS)
Principles and Best Practices in Afterschool Programming (AS)
Principles in Youth Work (AS)
Introduction to Human Services (AA)
American Social Problems (AA)
Behavior Management in the Classroom (AA)
General Psychology (AA)
Human Growth and Development (AA)
Fieldwork in Human Services I (AS)
Fieldwork in Human Services I Internship (AS)
AS in Human Services – Youth Development (POC 2374)
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Course #
Area IV
MGF1106
SPC1017
ENC1101
ENC1102
THE1000
ARH1000
MUL1010
HUS2851
HUS2851L
SYG2000
HUS2308
HSC2100
SYG2361
SYG2430
Course Name
Any Course from Natural Science – Area IV
Liberal Arts Mathematics
Fundamentals of Speech Communication
College Composition I
College Composition II
Theatre Appreciation
Art Appreciation
Music Appreciation
Fieldwork in Human Services II (AS)
Fieldwork in Human Services II Internship (AS)
Introduction to Sociology (AA)
Psychotherapy: Theory and Practice (AS)
Health Concepts and Strategies (AA)
Death and Dying (AA)
Marriage and Family (AA)
BAS – Supervision and Management (Primary POC T701, Secondary POC 6387)
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Course #
Area II, III, IV, V
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ACG2022
FIN3400
GEB3213
MAN3025
MAN3240
BUL3130
ISM4011
MAN4120
MAN3301
MAN4504
GEB4891
MAN4802
MAN4401
GEB3375
GEB4113
MAN4162
GEB3453
GEB4935
Course Name
Any Course from Humanities – Area II, Any Course from Math – Area III, Any Course from Natural Science –
Area IV, Any History, Government, or Political Science course from Social Science – Area V
Financial Accounting (AA)
Principles of Financial Management (BAS)
Business Writing (BAS)
Administrative Management (BAS)
Organizational Theory and Management (BAS)
Legal and Ethical Environment of Business (BAS)
Management Information Systems (BAS)
Leadership Challenges and Supervision (BAS)
Human Resources Management (BAS)
Operational Decision Making (BAS)
Strategic Management & Decision Making (BAS)
Marketing for Managers (BAS)
Labor Relations Management (BAS)
Foundations of International Business (BAS)
Entrepreneurship (BAS)
Customer Relations for Business (BAS)
Business Ethics and Stakeholder Management (BAS)
Capstone Experience: General Management (BAS)
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Participation Agreement
In the event I am awarded a Prime Time Professional Development Scholarship, I agree to:
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Notify Prime Time of any changes in my work status. I understand that if I am no longer employed with my
afterschool program during the time of my scholarship award, and I do not notify Prime Time, I may be exempt
from future Prime Time scholarship opportunities.
Attend and complete all required coursework, conference, workshop, or seminar sessions.
If I am unable to go to a conference, workshop, seminar, or event I have received a scholarship to attend, I must
notify Prime Time in writing within 15 business days of the event start date. Failure to do so may exempt me from
future Prime Time scholarship opportunities.
If I am unable to go to a class I have received a scholarship to attend, I must contact the college and drop the class
immediately. In addition, I must notify Prime Time in writing that I will be unable to attend and submit proof I
have dropped the class within three business days of the class start date. I also must return my books within the
drop/add period or I will forfeit future Prime Time scholarship benefits, and I will be liable for said book fees.
Failure to do so may exempt me from future Prime Time scholarship opportunities.
Submit proof of completion within 10 business days after the event end date. For classes, proof of completion is
my unofficial student transcript and a copy of my DCF transcript, if applicable. In addition, if I have completed the
Foundations of Advancing Youth Development course I will submit the certificate I received upon completion of
the course. For conferences and events, proof of completion is a copy of my certificate of attendance with the
presenter’s signature. Failure to submit scholarship follow-up information may exempt me from future Prime
Time scholarship opportunities.
I,
(applicant’s name, please print), attest that
the information contained in this application and the supporting documentation is true to the best of my knowledge.
I allow the Prime Time Palm Beach County, Inc. Scholarship Coordinator to access my FL Department of Children and
Families (DCF) and Palm Beach State College (PBSC) records to verify transcript information and confirm scholarship
eligibility.
Signature:
Date:
If you are taking Palm Beach State College classes, please complete this section.
In signing this scholarship application, I am also giving permission for Palm Beach State College to transmit my personal
identifiable student information such as registration status, courses and grades to Prime Time Palm Beach County for
☐ Spring
☐ Summer
the following term: ☐ Fall
PBSC student ID:
Your agency/center director must complete this section in order for you to be eligible for this scholarship. If you are
the director of your program, you must obtain the signature of your supervisor.
In the event my employee is awarded a scholarship, I agree to:
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Notify Prime Time of any changes in my employee’s work status, especially if he/she is no longer employed at the
agency/center.
Ensure completion and submission of all required follow up material.
Director’s or Supervisor’s printed name:
Director’s or Supervisor’s signature:
Date:
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