LISTAS Youth Leadership Program - Student Application

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The LISTAS Youth Leadership Program (LYLP) was created to expose and motivate young women and their families to pursue careers in historically underrepresented fields through partnerships with local colleges, universities and organizations. The LYLP includes mentoring, college preparation, personal and professional life skills, and an immersion of careers in STEM2 (Science, Technology, Engineering, Math and Management) through interactive STEM activities and workshops.

APPLICATION IS DUE ON JANUARY 15, 2020

PROGRAM DATES:
Feb 22 - Orientation (Parents/Students/Mentors)
Mar 07 - Session 1
Mar 21 - Company Visit/ Museum
Apr 04 - Session 2
Apr 18 - CAL Day
May 02 - Graduation

STUDENT INFORMATION

First Name *

Last Name *

Address *

City *

State *

Date of Birth *

YYYY

Language(s) Spoken at Home *

English

Spanish

Other:

Required

Home Phone *

Student Mobile Phone *

HUSD School Name *

Anthony Ochoa

Bret Harte

Cesar Chavez

Martin Luther King, Jr.

Winton

Other - Specify HUSD school name below

If "Other" what Hayward Unified School District school do you attend?

Grade Level *

7th

8th

9th

Other:

Dietary Restrictions or Allergies: *

Do you have access to a computer with internet at home? *

Yes

GPA (example: 3.2) *

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