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APPLICATION
YouthPower Leadership Institute
Fall 2017 Session for Black Boys & Young Men

Who Can Apply:

Black boys and young men ages 13-19 who currently participate in St. Paul Youth Services' Behavior Intervention, Diversion, or Children's Crisis Response program(s). 

Your application must include the name of a St. Paul Youth Services staff member who will serve as a personal reference for you. All information you provide to us will be kept confidential.

This program is meaningful and challenging, with high expectations and high support. Participants must meet all program expectations to earn the stipend and maintain their enrollment in the session. These include but are not limited to: regular attendance, wearing the tshirt (provided) during all YouthPower activities, creating an inclusive and positive community, contributing to all discussions and participating in all activities, demonstrating leadership, meeting all expectations, and taking responsibility for your behavior.

Name *
Name
What St. Paul Youth Services Programs are you a participant in? *
Only youth who are participants in St. Paul Youth Services' programs are eligible for YouthPower.
Phone *
Phone
Address *
Address
Parent/Guardian *
Parent/Guardian
Parent/Guardian Phone *
Parent/Guardian Phone
If currently enrolled
Please provide the name of the St. Paul Youth Services STAFF MEMBER who will provide a personal reference for you. Do not list other youth as a reference.
Please list 5 skills, strengths, or talents you can contribute.
Please list work, volunteer, or extracurricular activities you've been involved in.
What's a community issue or injustice you think should be addressed. Why? And what should be different?
Please describe a situation in which you demonstrated leadership and what happened as a result.
Can you share a time you set a goal and what you did to achieve it? What's something you'd like to learn, become, or accomplish in the future?
Please describe a positive group activity (in school, at work, or in life). In what ways did the group work well together? What role did you play?
Can you share an important person, experience, or work of art (movie, book, song, etc.) that has affected you and why?
Terms *
By checking this box, I understand that I must maintain regular attendance, meet all expectations and requirements, and fully participate in all program activities to remain enrolled in the program for the session.