CPA Shared Stories Student Application
Thank you for your interest in being a Shared Stories Participant. Shared Stories educates and empowers young people to become advocates for our communities. Focusing on issues that directly impact immigrant communities, youth gain awareness about social issues that have shaped Asian America and develop leadership skills through projects and activism for social change.

Please fill out the application below. If you have any questions, you may contact the Chinese Progressive Association at: 212-274-1891 or email to cpanyc@cpanyc.org. Applicants who are being considered will be called for an interview.
Today’s Date: *
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English Name: First, Last *
Grade/Year in school: *
Address: *
Telephone: *
Cell Telephone:
Email Address: *
I am a: *
Name of School (if applicable):
Age:
How did you hear about Shared Stories? *
How long have you been in this country? *
What languages are you proficient in? *
Parent/Guardian Name: (if under 18 years old)
Relationship to applicant:
Parent/Guardian Phone number:
1. What are the top three things you want to learn in this program? *
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2. What are three strengths you have that would help you contribute to this program? *
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3. In Fall 2014, the Shared Stories theme will focus on immigrant rights and civic participation. Which TWO projects would you be most interested in working on? *
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4. What themes or topics are you interested in? *
(Check as many as you would like)
Required
5. Is there anything else you would like to tell us about yourself?
6. Paste your resume below. (if available)
Volunteering with CPA:
Are you interested in volunteering with CPA? *
Which topics are you interested in?
(Check as many as you would like)
How many hours a week can you volunteer?
Which days can you volunteer?
(Check all that apply)
Are you interested in an internship?
Clear selection
How did you hear about CPA?
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