YWWAV Fall 2016 Application
Young Women With A Vision (YWWAV) is WWAV’s new weekly after-school program for high school aged Black girls in New Orleans (and those within that age range outside of traditional school systems). Recognizing a lack of programming that specifically explores the experiences of and promotes the leadership of Black girls in New Orleans, YWWAV is a program rooted in leadership development and promoting sisterhood among Black women and girls in New Orleans that takes place Tuesdays through Thursdays at the WWAV office located at 1226 N. Broad St. Please fill out this google form online or print a copy and drop off to 1226 N. Broad St. before
Email address
PARENT/GUARDIAN CONTACT INFORMAITON
First and Last Name
Your answer
Phone Number
Your answer
Email Address
Your answer
Do you have a car and are interested in signing up for a carpool for YWWAV for participants in your area who may need transportation assistance?
Preferred Contact Method
PARTICIPANT CONTACT INFORMATION
First and Last Name
Your answer
Street Address
Your answer
Apartment Number
Your answer
City, State
Your answer
Zip Code
Your answer
Birthdate (Monday/Day/Year)
Your answer
Age
Your answer
Gender
Your answer
Name of School
Your answer
School Type (ex: Charter, Public, Private, Other)
Your answer
Year in High School
If you are NOT a student, please provide the last school grade level completed
Your answer
If you are NOT a student, are you
Email Address
Your answer
Phone Number
Your answer
YWWAV IS COMMITTED TO UPLIFTING THE LEADERSHIP AND EXPERIENCES OF BLACK GIRLS IN AND FROM NEW ORLEANS. THE FOLLOWING QUESTIONS GIVE US A BIT MORE INFORMATION ABOUT YOU AND YOUR FAMILY (all information will be confidential)
What is your racial and ethnic background?
Were you born or raised in New Orleans?
What language(s) do you speak at home?
Your answer
Are you eligible for free and reduced lunch?
THIS SECTION ASKS A FEW QUESTIONS ABOUT YOU AND YOUR INTERESTS
If I could describe myself in 5 words I would say...
Your answer
If I could describe Black girls in 5 sentences I would say...
Your answer
What are some issues in your community you care about and why (ex: racism, unemployment, the environment etc)?
Your answer
Do you think of yourself as a leader? Why or why not?
Your answer
How do you want to grow as a leader in general?
Your answer
How do you want to grow as a leader through the YWWAV program?
Your answer
What are some topics you are interested in learning (more) about through YWWAV?
Your answer
What are your hopes for your future? (after high school, 5-10 years from now, etc.)
Your answer
How did you hear about YWWAV?
SCHEDULING AND TRANSPORTATION
What clubs, activities or youth groups are you already a part of (if any...it's OK if you are not part of any!)?
Your answer
What days and times do these activities meet?
Your answer
What days of the week are you available to join a YWWAV cohort? Check all that apply, you will be placed in one (note: Cohorts will meet once a week from 4-7pm at the WWAV office at 1226 N. Broad St)
Do you have transportation to the YWWAV program?
Is there anything else about yourself you'd like to share with the folks at YWWAV?
Your answer
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