Chicago Desi Youth Rising (CDYR) Application
Chicago Desi Youth Rising (CDYR) seeks to empower Chicago youth to combat racial, economic, and social inequity. CDYR is a weekend summer leadership retreat for youth ages 15 – 21 who trace their heritage to South Asia and the diaspora, and who want to grow as changemakers. Participants draw upon their diverse experiences and intersectional identities while they examine and challenge the underlying causes of their communities’ problems and conditions to become agents for social change.

This year's retreat will be held on August 11-13, 2017 at the University of Chicago.

To learn more visit: chicagodesiyouthrising.wordpress.com

General Information
We are excited and thankful for your interest in Chicago Desi Youth Rising. If you have any questions about this application or need any assistance filling it out, please do not hesitate to email us at chicagodesiyouthrising@gmail.com. Similarly, if an in-person interview would be a better or more accessible option for you than a written application, we would be happy to meet with you!

All responses to this application will remain between the applicant and Chicago Desi Youth Rising. All applications are due by Monday, March 27, 2017. Applicants will be accepted on a rolling basis.

Please do not worry about having perfect spelling or grammar on this application. Just fill these questions out in the best and most honest way possible.

First name *
Your answer
Last name *
Your answer
What gender do you identify with, and what pronouns do you use? *
Example: Pronouns she/her/hers, he/him/his, they/them/their
Your answer
Email address *
Your answer
Mailing address *
Your answer
Phone number *
Your answer
Date of birth *
MM
/
DD
/
YYYY
Does your family make *
If you are a student, what high school or college do you attend? *
Your answer
What is your grade level? *
Required
If you are a college student, what is your major?
Your answer
Identity & Heritage
Where in South Asia or the diaspora are your ancestors from? *
When we use the word 'desi' we are referring to people with origins in India, Pakistan, Bangladesh, Sri Lanka, Nepal, Afghanistan, Bhutan, and the Maldives. When we use the word 'diaspora' we are referring to people whose ancestors have ties to the above areas, but whose family's have migrated and built communities in other places -- from Fiji to Trinidad, from Kenya to the Persian Gulf, from South Africa to Guyana and Suriname, from Southall in Britain to Washington, DC and many places in between.
Your answer
Tell us a little bit about how and when you and/or your family came to the United States. *
CDYR is inclusive of adoptees and people who are undocumented, refugees, and asylees.
Your answer
Do you speak a language other than English at home? If so, which one(s)? *
Your answer
What cultural and/or religious background(s) did you grow up with? *
Your answer
Are there any other important identities that you have that you would like to share with us?
i.e. LGBTQIS identity, undocumented status, etc.
Your answer
Getting to know you
Please answer the questions below as best as you can. There are no right or wrong answers.
Why do you want to join Chicago Desi Youth Rising and what will you contribute to the group? *
Your answer
What issue or cause (in society, in your community, in your school, etc.) are you most passionate about, and why? If applicable, what have you done so far to learn about the issue and/or take action? *
Your answer
If you were asked to inform your classmates about an issue that you care about, how would you share this information with them? *
Required
How would you like to use the knowledge you gain at CDYR to benefit your community once the program ends? *
Your answer
Are there any specific topics that you are interested in learning more about? *
For example: South Asian history, community organizing, mental health, etc.
Your answer
Please answer the following questions.
Tell us about a time when you have experienced or witnessed racism, sexism, homophobia, religious discrimination, classism, or some other form of oppressive behavior. Describe what you saw, how you felt, what you did, and how that event impacted your viewpoints. *
Your answer
Tell us about a time when you have taken some sort of action to stop racism, sexism, religious discrimination, classism, or some other form of oppressive behavior. If you have not taken an action, describe a time when you wish you had taken an action and why you did not. *
Your answer
Logistics
CDYR registration is $50 for 3 days of lodging, meals, and workshops. However, no participant will be turned away due to financial need. *
Required
Do you have accessibility, medical, or other needs you'd like us to know about?
Your answer
How did you hear about us? *
Example: Facebook, website, mailing list, parent, friend/family member, teacher
Your answer
If selected, do you agree to respectfully participate in discussions and help create a sense of community? *
Your answer
Rangoli
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service