Advisory Panel on Student Concerns ... - College Board



Instructions for completing the APSO Nomination Form

Deadline for submission: 5:00 p.m. (EST), Friday, June 7, 2013

General information

Nominations forms will be accepted from schools from the following regions: Middle States Region, Midwestern Region, New England Region, Southwestern Region, and Western Region

• We are unable to consider students living abroad the U.S. continent.

• One application per school (member institutions will be given preference).

• Nominee must be entering junior year (11th grade high school) for fall 2013-14 school year.

• If you are handwriting the application, use print letters; cursive is illegible on fax transmissions.

• Full details and downloadable forms on the web page:



Part I – For the student

• Include the best telephone number to reach you at home or by cellular.

• Attach a biographical essay (200 - 400 words) of your educational, extracurricular, or civic experiences and why you would like to be part of the Advisory Panel on Student Opportunity.

No resumes, transcripts, or photos.

• Check the appropriate boxes if you have used any of the indicated College Board programs/services. If you have no experience, check off “No Experience”.

Part II – For the counselor or teacher

Attach a one-page statement as to why this student would excel at representing students from your school and from across the nation to a national advisory body. Please include how long you’ve known the student and in what capacity.

Part III – For the parent/guardian

• Read and sign pages 1, 2, 3, and 4 of the nomination form

• Review sample schedule (download at )

• Review FAQ (download at )

• Call me directly with any questions at (212) 713-8192

How to submit the application

Send completed 4-page application, biographical essay, and one-page statement by mail, fax or email. Do not send duplicate copies. A receipt will be sent via email. On Monday, August 19, 2013, nominee and counselor/teacher will be notified of status via email.

Mail College Board

Ivette Castro

Advisory Panel on Student Opportunity

45 Columbus Avenue

New York, NY 10023

Fax (212) 246-4668

Electronic Scan the completed application in PDF format and email to apso@.

Advisory Panel on Student Opportunity (APSO) Nomination Form

Return by Friday, June 7, 2013 to: Ivette Castro / apso@

The College Board

45 Columbus Avenue

New York, NY 10023

Fax: (212) 246-4668

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Part 1: To be completed by student

Name: _______________________________________ School: ________________________________________

Expected Year of High School Graduation: ______________________________________________________

Home Address: _______________________________________________________________________________

City: ___________________________________________ State: ___________ Zip: ________________________

Telephone: (_____)_______________________ E-mail: ______________________________________________

Student: Attach a biographical essay (200 - 400 words) of your educational, extracurricular, or civic experiences and why you would like to be part of the Advisory Panel on Student Opportunity. No resumes, transcripts, or photos, please.

Check the appropriate boxes if you have used any of these College Board programs/services: ( No Experience

□ PSAT/NMSQT®

□ SAT® and/or SAT Subject Tests™

□ College-Level Examination Program® (CLEP®)

□ Advanced Placement Program® (AP®)

□ CollegeEd®/MyRoad™

□ CSS/Financial Aid PROFILE®

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Part 2: To be completed by high school counselor or teacher

Name: ______________________________________________ Title: ___________________________________

School: ______________________________________________________________________________________

Street Address: _______________________________________________________________________________

City: _____________________________________________ State: ____________ Zip: _____________________

Telephone:_(_____)_______________________ E-mail: ______________________________________________

Counselor/Teacher: Attach a one-page statement as to why this student would excel at representing students from your school and from across the nation to a national advisory body. Please include how long you’ve known the student and in what capacity.

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Part 3: To be completed by Parent/Guardian

Parent/Guardian ________________________________________________________________________________

Parent/Guardian Contact Phone Number: ___________________________________________________________

I have read the attached APSO description, Code of Conduct, Unsupervised Activities Release, Insurance Statement, and Model Release and understand that as part of the APSO, my child will be traveling on his/her own to meetings across the country at the College Board’s expense. I consent and agree to the nomination of my child.

_____________________________________________________________________________________________

Parent/Guardian Signature

APSO Description and Release

Since 1978, students have impacted the College Board’s national advisory structure of the College Board through their participation in the Advisory Panel on Student Opportunity (“APSO)”. Throughout this time, they have demonstrated the importance of student perspective to the staff, and to the other councils and committees on which they serve.

We are looking for students who will be high school juniors in the 2013–14 school year. Students serve a three-year term, generally ending their participation after their first year of college.

Potential student panel members should be interested in education and community affairs. They should be comfortable with and respectful of peers from different backgrounds. As they will represent the student perspective from across the county, students who are outgoing and articulate seem to find the most benefit from this experience. Students must be able to travel independently several times a year without negatively impacting their studies or other extracurricular activities.

APSO members are expected to commit to the following:

• Attend three annual APSO meetings (National Forum in October and AP Annual Conference in July).

• After the first year, panel members are asked to attend additional assigned committee or council meetings in December and in May.

• Continued membership on the APSO is contingent upon regular meeting attendance.

All conference fees, travel and lodging expenses will be paid by the College Board.

We have read and understood the above:

________________________________________________________________________

Student Signature Date

________________________________________________________________________

Student Printed Name

________________________________________________________________________

Parent/Guardian Signature Date

________________________________________________________________________

Parent/Guardian Printed Name

Code of Conduct Release

(To be signed by student participant and parent/guardian)

I certify that I/my child will abide by the laws and standards of the United States and the State of New York during my/my child’s participation in the APSO Program (“Program”). I/my child will also comply with the College Board’s rules, standards and instructions for participant behavior. I understand that the College Board has the right to enforce the standards of conduct described herein, in its sole judgment, and that it may impose restrictions, up to and including removal and termination from the Program, for violating these standards or for any behavior detrimental to or incompatible with the interest, harmony and welfare of the College Board, the Program and other Program participants.

____________________________________________________________________________

Student Signature Date

____________________________________________________________________________

Student Printed Name

___________________________________________________________________________

Parent/Guardian Signature Date

___________________________________________________________________________

Parent/Guardian Printed Name

Unsupervised Activities Release

Please initial which directive you choose to provide to the College Board.

__________ I understand that my child may leave the hotel unsupervised while not engaged in Student Panel activities. I grant my child permission to leave the hotel and expressly release the College Board and its officers, employees, agents and designees from any and all claims, known or unknown, arising out of or connected with my child’s activities while unsupervised.

__________ I understand that my child may leave the hotel unsupervised while not engaged in Student Panel activities. I do NOT grant my child permission to leave the hotel unsupervised and desire that my child stay with the confines of the hotel when not engaged in Student Panel activities. I have discussed this with my child, however should my child leave the hotel without permission and unsupervised, I expressly release the College Board and its officers, employees, agents and designees from any and all claims, known or unknown, arising out of or connected with my child’s activities while unsupervised.

___________________________________________________________________________

Parent/Guardian signature Date

Insurance Statement Release

I represent and warrant that my child is represented by a policy of comprehensive health insurance which provides coverage for illness or injuries sustained or experienced while participating in the Program. I understand that the College Board does not provide health insurance for Program participants, and I agree to be financially responsible for any medical bills and related expenses incurred as a result of emergency medical treatment.

_______________________________________________________________________

Parent/Guardian signature Date

________________________________________________________________________

Parent/Guardian

________________________________________________________________________

Name of student participant

Model Release

I/we consent to be to photographed and/or recorded by the College Board and/or its agents and grant permission to the College Board and its licensees to use, display and publish these photographs and/or recordings, in print materials and publications, on websites, and in other formats now known or hereafter developed, for both commercial and non-commercial use. I understand that the term "photograph" as used herein encompasses both still photographs and motion picture footage.

I/we further consent to the College Board’s use of the photographs and recordings of my voice, without further compensation to me and without obtaining any additional permission from me.

I/we release the College Board and its affiliates and licensees from any and all claims associated with the use of my photographs and/or recordings.

I/we have read and understand to the terms of this release.

______________________________________________________________________

Student Signature Date

______________________________________________________________________

Student Printed Name

______________________________________________________________________

Parent/Guardian Signature Date

______________________________________________________________________

Parent/Guardian Printed Name

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