Peer to Peer Program Application

APRIL's Peer-to-Peer Mentoring Program encourages leaders with disabilities who are subject experts on a variety of topics related to rural America and disability to share their knowledge and expertise with Centers for Independent Living (CILs) and Statewide Independent Living Centers(SILCs) across the United States and its territories.

CIL to CIL Mentoring is typically done with an Executive Director of a CIL to another Executive Director of a CIL. We will also consider Assitant Directors other subject matter experts, such as Youth Coordinators, Nursing Home Transition Coordinators, Program Managers/Assistant Directors, etc.
SILC to SILC Mentoring is typically done with SILC staff to SILC staff. We can offer a SILC Chair mentor on a case-by-case basis.

Please fill out the information below so that we can match you with a mentor that meets your needs.

For more information or assistance in applying contact Rebecca Roberts, Director of Training and Technical Assistance at rroberts@april-rural.org.

Please indicate below which mentoring program you are applying for:

CIL to CILSILC to SILC

Name

First NameLast Name

Organization

Executive Director name and e-mail if other than applicant

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email

example@example.com

How many staff work for your organization (not including volunteers)?

Current Position:

Please indicate below the amount of time you have been in your current position:

Please indicate below the amount of time spent in the Independent Living field overall:

Please indicate below the areas that best describe your overarching goal you are seeking support for:

Please use as much space as you need to describe specific issues or barriers you’re facing and what outcomes you would like to achieve through this mentoring. Please include as much detail as possible to help us find the right potential match for you. (Why are you applying for mentoring services?)

What steps (if any) have you and others at your organization already done to address the above issues or barriers? (For example, trainings on this topic you have already accessed, services with Paula McElwee with the IL-NET, if you have already had a mentor, connections with state networks, and other creative solutions you have tried.)

Can you think of anything else that might be useful for us to know about your request? Do you have preferences of potential mentors you would like to work with such as must be rural or must serve youth?

How did you hear about us?