Septima Clark Community Power Institute 2013 Registration
Race and Education: Colonial Roots, Liberation Future
2013 Summer Youth Fellowship Application: June 17-July 15

Applications are due no later than May 17th, 2013
Applications are accepted via email, US mail or delivered in person.
In addition to this form, you must also submit Recommendation form. An adult or peer from an organization, community group or academic institution, must complete this recommendation. (i.e. nonprofit, school, church, after-school program).
Download all forms at

For assistance or questions, call 404-622-0602 or email
SCCPI takes place at 9 Gammon Ave SE, Atlanta GA 30315

In its 6th year, The Septima Clark Community Power Institute (SCCPI) will provide youth ages 14-19 with the opportunity to develop as leaders, critical thinkers, and community organizers. The SCCPI is named after the great Movement leader from South Carolina, Septima Clark, and continues her legacy of leadership development and education for social justice. The SCCPI is designed for young people who are interested in making positive changes in their community and will teach the skills, thinking and history of community organizing, social movements, and the important role of the US South.

Each summer the SCCPI centers on a theme that relates to larger issues and opportunities within social justice movements. Over the last decade, the nation has witnessed the massive breakdown of the educational system as a whole. With the constant privatization of education, the closure of public schools, and the very intentional underinvestment of state dollars to educational institutions that mostly serve youth of color, disparity is at an all time high. Low-income households and children bear the brunt of the broken-down school systems.

Over the last two years, we have witnessed the incarceration of many teachers and administrators, many of whom served in the Atlanta Public Schools System. Though this particular situation may appear to have clear lines of right and wrong, or even seem to be isolated incidents, this scheme is a part of a larger attack on black youth, black families, and black teachers. Youth are not being afforded the opportunity to gain the necessary skills they need to survive outside of the constructs of schools and are literally being left behind, which is evident in their performances on standardized tests.

SCCPI fellows will participate in workshops, critical discussions, community outreach, research, outings, and other activities to develop leadership and organizing skills that will help them think critically about education and the world around them. The SCCPI combines learning and hands-on practice to develop youth leadership and youth-led organizing capacity.

The duration of the Institute is four weeks. All accepted applicants will receive a stipend based on their full participation in the program. Participants will meet a diverse group of youth, community organizers, educators, and activists and youth will have the opportunity to lead an organizing process towards youth power in Atlanta.

In July 2011, the participants attended the Free Minds Free People Conference in Providence, RI. They participated in a Youth-led assembly discussing the National Students Bill of Rights, which led to the birth of NSBR organizing. This year, the SCCPI participants will have the opportunity to attend another exciting Free Minds Free People conference in Chicago, IL on July 11th-14th.

Youth Application
This application will not be processed unless all information is completed. Please complete each question
First Name *
Your answer
Last Name *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Home Phone *
Your answer
Mobile Phone *
Your answer
Email *
Your answer
How often do you check email? (Choose one) *
Date of Birth *
Your answer
Age *
Your answer
Gender *
Race/Ethnicity *
Education information
Name of high school/college you attend (if applicable)
Your answer
Year in High School (if applicable)
Year in College (if applicable)
Other forms of education
Your answer
Youth Applicant Skills and Interests
Please include brief responses to the following questions.
Special Skills: (i.e. speak foreign language, performing arts, etc.) *
Please briefly explain how these skills may benefit other Institute participants and your community (2-3 sentences).
Your answer
Career Interests/Current life goals: *
Please briefly explain how you feel the Institute will support you in reaching your goals (2-3 sentences).
Your answer
Extracurricular Activities: *
Your answer
How did you hear about the Septima Clark Community Power Institute? *
What method of transportation will you most likely use to get to and from the Institute? *
List ALL other commitments that will affect your availability during the summer internship program (i.e. summer school, camps, family vacation, etc.): *
Your answer
Short Answer Questions
What do you feel is the most pressing issue facing your community in Atlanta today? Please Explain: *
Your answer
Do you believe that youth can positively and dramatically effect change in their communities? *
If yes, how? What were some immediate and long terms actions that can be taken to develop solutions? If no, Why not? (6-8 sentences) *
Your answer
Youth / Parent Consent
To the best of my knowledge, the information given in this application is accurate and complete. If chosen for the Institute, I agree to make a commitment to participate and follow program and training rules and regulations.
Electronic Signature of Youth Applicant *
Your answer
Date of Signature *
Your answer
Electronic Signature of Parent/Guardian
Parental/Guardian consent is required if applicant is under 18 years of age
Your answer
Parent/Guardian Work Phone
Your answer
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service