AACI AMPLIFY Application
AMPLIFY is an arts & media program that looks empower youth through creative arts. We use arts & media as a tool to develop leadership skills and community involvement among youth ages 10 - 18.

Weekly Meetings:
Tuesdays, Wednesdays, and Thursdays

Summer Session - July 11th to August 31st, 2017
School Year - October 2017 to June 2018

• Must be age 10 through 18 at the time of enrollment
• Must live in the Santa Clara County
• Must have transportation to and from our office

Daily Schedule:
3PM – 4PM: Homework and Recreational Time
4PM – 6PM: Group Activities

Groups Available:

General Interest (4PM – 5PM)/(4PM - 6PM during Summer)
For youth who only have a basic interest in arts & media, are looking to explore new activities, or are looking for something more drop-in friendly.
Recommended Ages: 10 - 12

Deeper Interest (4PM – 6PM)
*One day a week (Thursdays) - other days open for additional mentoring
For youth who have a strong interest in arts & media and are looking to develop long-term creative and leadership skills. Weekly commitment required.
Recommended Ages: 13 - 18

Activities provided at:
AACI Story Road Office
749 Story Road, Suite 50
San Jose, CA 95122

Applications will be accepted any time. If the current session is full, you will be placed on a waiting list.

For all questions and concerns, please contact amplify@aaci.org or 408-975-2730 ext. 404

*AMPLIFY is a program of Asian Americans for Community Involvement (AACI). Services from AMPLIFY are funded by Santa Clara County Behavioral Health Services Dept. - Substance Use Prevention Services and the Social Services Agency.

First Name
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Last Name
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Phone Number
Best number to contact you. Please enter 10 digit phone number only with no dashes or parentheses. Ex. 1234567891
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Parent/Guardian Emergency Contact Name
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Parent/Guardian Emergency Contact Number
Please enter 10 digit phone number only with no dashes or parentheses. Ex. 1234567891
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What is your preferred method of contact?
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Address of Residence
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Name of School
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During the summer, please choose the grade you will be entering.
Which group are you interested in joining?
Have you ever participated in any of AACI's youth programs?
If yes, what AACI youth programs have you participated in? When?
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Do you have any medical conditions or dietary restrictions/allergies or learning difficulties we should be aware of?
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How did you hear about us?
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Please let us know if you have any additional questions, concerns or comments.
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