Catalyst Institute - Applicant Registration Form
We are so glad you are interested in engaging your faith in the service of your city! We need more young people like you.

The mission of PFMR’s New Haven Catalyst eight-week summer pilot is to equip 12 Muslim and Christian young people around New Haven with the skills needed to facilitate sustainable, replicable peacebuilding projects. The pilot project will enhance community resilience and strengthen foundational structures for community development, building your capacity to heal from trauma and equipping you with productive strategies to tackle tough issues.

Contact laqruishia.gill@pfmr.org with any questions regarding this program.

See our website for more information about Pathways: pfmr.org
CONTACT INFORMATION
Full Name *
Age & Grade *
Email address *
Phone number *
City of residence
Name the local religious institution(s) you are affiliated with. Include the name of your local faith leader. (The latter could be a pastor, Imam, youth leader, etc.) *
This program runs from June 26th through August 16th and meets weekly, Tues-Thurs. List any known conflicts with this schedule: *
SKILLS & EXPERIENCE
Do you belong to any community, student or professional organizations, faith-based or otherwise? Describe your involvement.
What are your hobbies?
EVALUATIVE QUESTIONS
Why are you interested in our Catalyst Institute? *
Describe your interest in the fields of peacebuilding, Muslim-Christian relations, and multi-faith activism. *
What are your long-term education or career goals? *
Describe relevant leadership experiences.
Describe relevant cross-cultural or travel experiences. How did these affect you?
REFERENCES
Please provide three references, one of which must be a parent or guardian.
Reference 1: Name, relation, and contact information *
Reference 2: Name, relation, and contact information *
Reference 3: Name, relation, and contact information *
Use the space below to list any food preferences/allergies, and other relevant comments that have not been addressed.
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