CLASP Application
Summer 2020 Application for the Community Leadership, Action and Service Program.
Last Name *
Your answer
First Name *
Your answer
Campus Address
Your answer
Home/Permanent Address
Your answer
Cell Number *
Your answer
Scarletmail Email *
Your answer
Personal/Preferred Email
May be the same as above.
Your answer
RU ID Number *
Your answer
Which college are you enrolled in? *
Major(s)/Minor(s)/Certificate(s) *
Your answer
GPA *
Your answer
Year of Graduation *
Your answer
How would you describe your racial and/or ethnic identity? *
Check all that apply
Required
How would you describe your gender identity? *
Check all that apply
Required
How would you describe your sexual identity? *
On a scale of 1 to 4 , please rate your level of oral proficiency (2-Beginner , 3-Conversational) in Spanish. *
No proficiency
Native or bilingual proficiency
Please list any other languages that you speak, read or write. Please indicate your proficiency level. *
Your answer
Please indicate any internship site preference you may have: *
Some of the sites can be found on our website at https://iwl.rutgers.edu/clasp-summer-program/
Required
How did you hear about the program? *
(check all that apply)
Required
List any courses relevant to CLASP. These may include courses focusing on social justice, public health, economics or Women's and Gender Studies. *
Your answer
Do you plan on receiving credit for CLASP ? *Please note you would need to pay tuition and register for a summer course if you receive credit* *
If you plan on receiving credit, which department is the credit going towards?
Your answer
Where will you be residing during the summer? If you are commuting, which town will you be commuting from? *
Your answer
List your experiences relevant to CLASP. For example, this may include experience in teaching or education, healthcare, or literacy training; mentoring, visual, performance or literary arts; working with children; working with at-risk teen; or community service, etc.: *
Your answer
What do you expect to gain through participating in CLASP? *
Your answer
How do you feel about working in a diverse community? How do you adapt to challenging environments and relationships? Please give concrete examples. *
Your answer
Do you anticipate any conflicts with the CLASP Program during Summer Session III (vacation, work, etc.)? *
Your answer
Recommendation Form
List the name, title, AND contact information of the person you wish to fill out the recommendation form. Recommendations from Rutgers faculty/advisers or community leaders are preferred.

It is important that you reach out to a potential reference and let them know that they will be receiving a form via e-mail to fill out.

After providing us with this information, we will reach out to your reference at the e-mail address provided with a form. This electronic recommendation must be filled out by March 22nd.
Reference Name
Your answer
Affiliation/Title
Your answer
Reference Email Address
Your answer
Required Essay
A 500 word essay on the following topic: Write an essay describing a social, political or economic issue that is important to you.
Answer Essay Question *
Your answer
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