Design to Better [Our Community] Summer Academy
Program Lead Application - Summer 2018
For full program details, please visit: http://www.creativereactionlab.com/design-to-better-our-community/

A PDF version of the application is available for viewing here: http://bit.ly/2m4UrlN

We encourage you to use the PDF to prepare your answers, but ask that you use this online form to submit. 

Applications are due on February 5, 2018 at 11:59 PM CST.

If you have any questions about the program, please contact Erika Harano at eharano@creativereactionlab.com.
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PART 1: THE BASICS

 
What is your name? *

 
What are your pronouns? *

e.g. he/him, she/her, they/them, ze/zir
 
What is your street address? *

 
What city do you live in? *

 
Which state do you live in? *


 
What is your zip code? *

 
What is your phone number? *

 
College/university you attend (or graduated from) *


 
Year of graduation *


 
What is your race/ethnicity? *

 
What is your gender identity? *

 
PART 2: INTEREST, SKILLS, AND EXPERIENCE

 
Why do you want to be a Design to Better [Our Community] Summer Academy Program Lead? *

 
Please complete the following sentence:  I will make my city better by ______________________. Then, please tell us why. *

As part of our Community Design Apprenticeship Program, we ask all participants to take a pledge to commit to bringing about change.
 
Please share your experience with positive youth development and/or youth engagement. *

 
Please share your experience with facilitating workshops, trainings, and/or educational programming. *

 
Please share your experience with supervising and/or managing other people. *

 
Please share your experience with designing and/or implementing program evaluations. *

 
Why do we need racial equity? *

 
How comfortable are you with the following topics and terms?

 
Entrepreneurship *


 
Creative Problem Solving *


 
Civic Engagement and/or Leadership *


 
Cultural History and Healing (specific to Black/African American and/or Latinx culture) *


 
PART 3: WRAPPING UP

 
Please provide a link to your Linkedin profile, online portfolio, or your resume. *

If you need to upload your resume instead, you'll be able to do so in the next question.
 
If you prefer to upload your resume, please do so here.

 
Reference #1: Please provide the name and contact information (email and/or phone number) of an adult that can speak on your character and professionalism. *

The adult reference can be a professor, mentor, dean, supervisor (including former), community leader, religious center leader, etc.
 
Reference #2 (OPTIONAL): Please provide the name and contact information (email and/or phone number) of an adult that can speak on your character and professionalism.

The adult reference can be a professor, mentor, dean, supervisor (including former), community leader, religious center leader, etc.
 
Reference #3 (OPTIONAL): Please provide the name and contact information (email and/or phone number) of an adult that can speak on your character and professionalism.

The adult reference can be a professor, mentor, dean, supervisor (including former), community leader, religious center leader, etc.
 
How did you hear about this program? *

 
Is there anything else you would like to share, or questions you have for us?

Thanks! We will review your application and be in touch with you shortly.
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