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This
SF Black Leadership Academy Inc. program is being funded through a grant from the
San Francisco Mayor's Office of Community Development (MOHCD)
, and a partnership with the
BrainWare Learning Company
and
MindPrint
to provide San Francisco Middle School Age Students (Ages 11 - 14 years) with a "Free" (no fees or charges)
Cognitive Capacity Building
Program
to teach our students to
"LEARN HOW THEY LEARN".
Students completing 1-3 below will be eligible to receive a
$300.00 Cash Gift Card:
1. Complete the MindPrint Pre-Test
2. Complete 18 0f 36 modules of the BrainWare Safari Program
3. Complete the MindPrint Post-Test
OUR SECOND COHORT IS LIMITED TO 10 STUDENTS . . .
THE ACTUAL CLASSROOM WILL BE LOCATED IN
DISTRICT 10 (Bayview) of San Francisco
and/or
DISTRICT 5 (Western Addition) of San Francisco
- The physical location or locations will be announced in early June of 2024
Please refer to the diagram on the right or below to learn more about the
Foundational Cognitive Skills
, etc.
www.mybrainware.com
Parent and Student Orientation & MindPrint Pre-Test:
Mon. June 10, 2024
6pm - 8:00pm
Parent and Student Orientation and MindPrint Pre-Test
Week 1 - BrainWare Safari
June 2024 Classes 10am - 2pm
Tues. June 11, 2024
Wed. June 12, 2024
Thurs. June 13, 2024
Fri. June 14, 2024
Week 2 - BrainWare Safari
June 2024 Classes 10am - 2pm
Mon. June 17, 2024
Tues. June 18, 2024
Wed. June 19, 2024
Thurs. June 20, 2024
Fri. June 21, 2024 (Makeup Day)
Week 3 - BrainWare Safari
June 2024 Classes 10am - 2pm
Mon. June 24, 2024
Tues. June 25, 2024
Wed. June 26, 2024
Thurs. June 27, 2024
Fri. June 28, 2024 (Makeup Day)
Final MindPrint Post-Test
Sat. June 29, 2024
10am - 1pm
Student Review and Final MindPrint Post-Test
Box Lunch served at 1pm
PLEASE SUBMIT YOUR APPLICATION AND INTEREST IN THE PROGRAM BY COMPLETING THE SURVEY BELOW:
SF Black Leadership Academy Application & the BrainWare Learning Company Cognitive Rating Scale (Ages 9-12)
Your data is confidential and will not be shared outside of the San Francisco Black Leadership Academy, BrainWare Learning, & MindPrint, who are all
Dedicated to protecting your students privacy.
*
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*
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If Other please specify:
*
PERSON PERFORMING THE EVALUATION
Name
*
First
Last
Email
*
Relationship with child
*
Parent
Guardian
Relative
Coach
Teacher
Other
Other
*
Enter the other relationship that is not listed
PERSON BEING EVALUATED
Date of Evaluation
*
Please Enter Month, Day, Year
Name
*
First
Last
AGE
*
PLEASE ENTER A NUMBER
Gender
*
Female
Male
Transgender
Gender Neutral
Non-Binary
Agender
Pangender
GenderQueer
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Email
*
Phone Number
*
ATTENTION SKILLS
1. Can sustain attention for appropriate periods of time in routine home and school situations
*
Significantly Below Average
Below Average
Average
Above Average
Significantly Above Average
2. Can maintain proper attention even when distractions are present
*
Significantly Below Average
Below Average
Average
Above Average
Significantly Above Average
3. Pays attention to details
*
Significantly Below Average
Below Average
Average
Above Average
Significantly Above Average
4. Listens carefully and maintains eye contact when being spoken to
*
Significantly Below Average
Below Average
Average
Above Average
Significantly Above Average
5. Finishes Tasks he or she starts
*
Significantly Below Average
Below Average
Average
Above Average
Significantly Above Average
6. Is organized (School Work, Bedroom, Etc.)
*
Significantly Below Average
Below Average
Average
Above Average
Significantly Above Average
MEMORY SKILLS
7. Can remember his or her address, his or her phone number, dates, names and other basic facts
*
Significantly Below Average
Below Average
Average
Above Average
Significantly Above Average
8. Can remember information learned for tests
*
Significantly Below Average
Below Average
Average
Above Average
Significantly Above Average
9. Remembers to do things he or she was asked to do
*
Significantly Below Average
Below Average
Average
Above Average
Significantly Above Average
10. Once he or she learns to do a task, remembers how to do it days or weeks later
*
Significantly Below Average
Below Average
Average
Above Average
Significantly Above Average
11. Can remember the details of a story that was just read to them
*
Significantly Below Average
Below Average
Average
Above Average
Significantly Above Average
12. Can remember the details of instructions given and carries out the instructions correctly
*
Significantly Below Average
Below Average
Average
Above Average
Significantly Above Average
PERCEPTUAL PROCESSING
13. Copies things accurately
*
Significantly Below Average
Below Average
Average
Above Average
Significantly Above Average
14. Does not make a lot of careless errors
*
Significantly Below Average
Below Average
Average
Above Average
Significantly Above Average
15. Can work on school work independently without much help
*
Significantly Below Average
Below Average
Average
Above Average
Significantly Above Average
16. Understands and does not get confused when instructions are given
*
Significantly Below Average
Below Average
Average
Above Average
Significantly Above Average
17. Can handle complex task requiring significant mental effort, without getting frustrated
*
Significantly Below Average
Below Average
Average
Above Average
Significantly Above Average
18. Completes homework or other tasks that require mental effort in the appropriate amount of time
*
Significantly Below Average
Below Average
Average
Above Average
Significantly Above Average
THINKING SKILLS
19. Learns from mistakes
*
Significantly Below Average
Below Average
Average
Above Average
Significantly Above Average
20. Plans ahead and uses forethought
*
Significantly Below Average
Below Average
Average
Above Average
Significantly Above Average
21. Uses Good Judgement
*
Significantly Below Average
Below Average
Average
Above Average
Significantly Above Average
22. Is good at finding solutions to problems
*
Significantly Below Average
Below Average
Average
Above Average
Significantly Above Average
23. Can predict the outcome of situations or stories
*
Significantly Below Average
Below Average
Average
Above Average
Significantly Above Average
24. Uses Imagination and creativity
*
Significantly Below Average
Below Average
Average
Above Average
Significantly Above Average
LIFE MANAGEMENT SKILLS
25. Manages time effectively
*
Significantly Below Average
Below Average
Average
Above Average
Significantly Above Average
26. Does not wait until the last minute to study for test
*
Significantly Below Average
Below Average
Average
Above Average
Significantly Above Average
27. Completes and turns in assignments on time
*
Significantly Below Average
Below Average
Average
Above Average
Significantly Above Average
28. Establishes Proper Priorities
*
Significantly Below Average
Below Average
Average
Above Average
Significantly Above Average
29. Is Organized
*
Significantly Below Average
Below Average
Average
Above Average
Significantly Above Average
30. Establishes short-term and long-term goals
*
Significantly Below Average
Below Average
Average
Above Average
Significantly Above Average
SELF ESTEEM
31. Has confidence in his or her learning ability
*
Significantly Below Average
Below Average
Average
Above Average
Significantly Above Average
32. Enjoys taking on challenging tasks
*
Significantly Below Average
Below Average
Average
Above Average
Significantly Above Average
33. He or she fells well-liked
*
Significantly Below Average
Below Average
Average
Above Average
Significantly Above Average
34. Bounces Back from failures or setbacks quickly
*
Significantly Below Average
Below Average
Average
Above Average
Significantly Above Average
35. Does not need a lot of reassurance in most areas of life.
*
Significantly Below Average
Below Average
Average
Above Average
Significantly Above Average
36. Exhibits good motivation and effort towards learning and school
*
Significantly Below Average
Below Average
Average
Above Average
Significantly Above Average
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