Young Men of Color (YMOC) Young Women of Color (YWOC) Summer of Activism 2024 Interest Form
The YMOC Summer of Activism is a summer program focused on healing, wellness, joy, career exploration, workforce development, higher education access and beyond. 
Food and transportation support will be provided. 

Because this is a 5 week program that includes an overnight trip to a higher education institution, we ask that you commit the entire time in order to receive the most out of the program.

We ask that the student complete this interest form with parent/guardian support. 

As a reminder:  Completing this Summer of Activism interest form does not automatically mean that you have been accepted into the Summer of Activism program.  Your next step from here is to receive a call, text or email for you to have an interview with one of the YAASPA staff members.  If you are selected from the answers you provide in the interest interview, the next step is to complete the official application which is different than this google interview form.  The official application form will be sent to you from CampMinder with all required forms included.  You will not be able to attend the program until all required forms are completed and added to your file.  
Sign in to Google to save your progress. Learn more
Email *
Student's First name *
Student's Last name  *
Student's Race 
Student's 1st language
Student's 2nd language (if applicable)
Because we will have activities that are gender focused, based upon particularly female and male identities, please indicate your gender below 
Clear selection
Student's school district for fall of 2023 (APS, CCSD, DPS)
Clear selection
Student's school attending spring of 2024
Student's school attending fall of 2024
Student's grade entering fall 2024
Clear selection
Student's Phone Number 
Guardian 1 name
Guardian 2 name
Email of guardian(s)
Phone number of guardian(s)
Who of the following are your greatest supporters?
Please check all that apply 
What career(s) do you hope to go into?
If selected for this program, which weeks are you able to attend Summer of Activism 9:30am to 3pm?

In order to attend this program you must be able to attend at least 4 of the 5 weeks.
 *
Required
What is your default means of transportation
Will you need transportation support in order to attend Summer of Activism?
Clear selection
Are you interested in learning more about  part-time paid work-based learning opportunities for this summer?
Clear selection
Why are you interested in this summer opportunity?
Does any of the following reflect why you are interested in this summer opportunity?
What ways do you think you can contribute to the learning of your peers?
Which of the following areas are you most interested in 
How you would rate your CURRENT academic efficacy. Academic efficacy is defined as:  Understanding of plan of action for decision making as it pertains to academic options for navigating career path whether career tech, college, or choosing to opt out of academic pathways
Low
High
Clear selection
How would you rate your CURRENT career efficacy:  Career efficacy is defined as: Competency of career options and increased employability via paid work-based learning.
Low
High
Clear selection
Please share your CURRENT confidence in intersectionality affirmation. Intersectionality affirmation is defined as:  Understanding and feeling their racial identity is layered and informs other identities alongside their identity development in academic and work-based spaces
Low
High
Clear selection
How did you hear about this program?
If you were recommended by someone, who recommended you?
Any questions and/or wonderings?
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Young Aspiring Americans for Social and Political Activism (YAASPA). Report Abuse
Google Forms