CLIA's 2017 Summer Leadership Institute
Have you been told you're a great leader, but not sure how to start? Is there an issue you're passionate about, but not sure how to approach it? Do you want to be a leader within your school and your community? Apply for Community Law In Action's (CLIA) Summer Leadership Institute.

Please fill out ALL of the questions below. Our Summer Leadership Institute will take place June 26 - July 21, 2017. We will meet 10am-3pm Monday through Thursday. You must be a rising high school Junior or Senior enrolled in Baltimore City Public Schools.

If you have any questions, don't hesitate to contact us. You can email our Program Coordinator, Ray Conaway at Raekwon@cliayouth.org or our Director of Education & Student Engagement, Natalia Skolnik, at Natalia@cliayouth.org

Name
First and last name
Your answer
Date of birth
MM
/
DD
/
YYYY
Mailing address (#, street name, city, state, zip code)
Your answer
Student ID number
Your answer
Email
Your answer
Phone number
Home and Cell Phone
Your answer
What school do you attend?
Your answer
For the 2017-18 school year, what grade will you be in?
Required
GPA (You do not need a certain GPA to be in this program. We want anyone who is interested in this program to apply. We just need to collect this for our own data and funders' requirements).
Your answer
Have you applied to other summer opportunities/programs?
Required
If yes, please list them below
Your answer
Is there a possibility you may have to attend summer school?
Required
Why are you interested in joining CLIA's Summer Leadership Institute? (max 150 words)
Your answer
What is your definition of a leader? (max 150 words)
Your answer
Describe a time you acted as a leader (e.g., group activity, sports, community activity)
Your answer
What do you feel are the biggest challenges affecting youth?
Your answer
What is your definition of advocacy? (max 150 words)
Your answer
During CLIA's Summer Leadership Institute, which of the following would you like to learn about? (check all that apply)
Required
Which advocacy issues would you like to focus on during the program? (check all that apply)
Required
List one adult (not a family member) as a reference to your application. Please include his or her email address, phone number, and relationship to you (e.g., teacher, coach, mentor).
Your answer
Please check the box if you have an IEP, 504 plan, or IHP. (Answering yes to any of these will not disqualify you from participating. It will only help our staff learn what kind of support our youth may need to thrive in our program, and will help us get ready before our program begins).
Do you have any questions for us?
Your answer
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