YW Boston’s Youth Leadership InItiative
Delegate Application for the Class of 2017 – 2018
YW Boston’s Youth Leadership Initiative (InIt) is a ten-month youth program that helps you become a social justice leader in your school and community. Through the program, you will:
· Have open and honest conversations about social justice issues like racism, sexism, LGBT and disability rights
· Develop leadership skills like how to bring people together and communicate powerfully
· Make friends with other high school students who care about social issues and want to take action
· Build your resume for college and work
· Make real change in your school and community!
InIt is made up of groups of students, called delegations, from high schools and organizations across the Greater Boston area. There are three to four students in each delegation.
Each class is diverse in terms of race, gender, class, sexual orientation, neighborhood, school, and many other identities. You will get the chance to build community with and learn from people of different backgrounds and life experiences.
Here’s what some InIt delegates have said about the program:
"InIt was life changing on a seismic level. It changed the way I move through the world and taught me not to be afraid of my own voice." - Jackson, St. John's Prep, InIt ‘17
“Absolutely amazing. I came here knowing only 3 other people and left with a whole family.” - Kathryn, Excel Academy Charter School, InIt ‘17
“InIt has helped me learn to interpret my emotions. I know how to take my anger and discomfort and harness it into something useful, something worthwhile.” - Lydia, Milton High School, InIt ‘16
“You learn so much from not just books and statistics, but from your friends and their experiences, and to me that's the most effective way to learn”. – Liliana, Boston Latin School, InIt ‘17
“This was a beautiful, beneficial experience that I wouldn't have missed for the world. Thank you for allowing me to grow, learn to listen, and find the desire to enlighten myself and be a light to others.” – Geo, Brimmer & May School, InIt ‘17
Programming will run from August 2017 to May 2018. Delegates are required to attend all program activities. Applicants who cannot attend Immersion Week will not be accepted into InIt. Before applying, please ensure you can attend all of the dates listed below.
A five-day overnight retreat to explore how identity impacts your life, and the lives of those in your community, through open conversation on social justice issues.
Date: Monday, August 14 - Friday, August 18, 2017
Location: Camp Cedar in Casco, Maine (transportation provided)
Interactive workshops and community learning to develop your leadership skills and deepen your understanding of social justice issues. Topics include: immigration, education, health equity, food justice, criminal justice system, housing equity. Program Days are held on Saturdays from 9:00 am to 5:00 pm unless otherwise noted; dates subject to change.
2017 Dates: September 16, October 21, November 18, December 16
2018 Dates: January 27 (Social Justice Arts Slam, 1:00 – 8:30 pm), February 24,
March 24, April 21, and Thursday, May 10 (Graduation, 3:00 – 8:00 pm)
Location: Meet at YW Boston, 140 Clarendon Street, Boston, MA
Together with the other students in your delegation and with coaching and support from InIt staff, you will design and create a project to improve your community. Past examples have included starting social justice clubs, creating art projects, advocating for policy change, and facilitating workshops for fellow students.
For your application to be complete, it must include:
1) Background Information (page 3)
2) References (page 4)
3) Activities and Experiences (page 4)
4) Personal Statement Part A (page 4)
5) Personal Statement Part B (page 4)
6) Student Signature (page 4)
7) Parent/Guardian Statement of Commitment (page 5)
Applications may be completed and submitted online at www.ywboston.org/init, or submitted by:
Mail: Kaitlin Pang, YW Boston, 140 Clarendon Street, Boston, MA 02116
Email:
Fax: Attn: Kaitlin Pang, YW Boston, 617-585-5489
Applications will be accepted beginning in January 2017 and qualified students will be interviewed beginning in March. We are still accepting applications for our second round deadline, May 30. We will contact you to schedule an interview upon receiving your application. If you have any questions, please contact: Kaitlin Pang, InIt Recruitment Coordinator, at 617-585-5489 or .
1: Background Information
Full Name: / Preferred Name/Nickname:High School: / Expected Graduation Year:
Date of Birth (Month/Day/Year): / Gender:
Race or Origin (Select all that apply):
¨ Black or African American
¨ Hispanic, Latino/a/x, or Spanish origin
¨ Middle Eastern/North Africa
¨ White
¨ Asian
¨ American Indian/Alaskan Native
¨ Native Hawaiian/Pacific Islander
¨ Other: / Pronouns:
Unisex T-shirt Size:
Cultural/Ethnic Identification:
Country of Birth:
Religious Identification or Affiliation:
Primary Language (Select up to two):
¨ English ¨ French
¨ Spanish ¨ Portuguese
¨ Mandarin ¨ Cantonese
¨ Vietnamese ¨ Cape Verdean
¨ Haitian-Creole ¨ Korean
¨ Russian ¨ Other: / Address:
Street Address:
Apartment or Unit:
City:
State: Zip Code:
Neighborhood of Residence:
¨ Allston ¨ Downtown ¨ Mattapan ¨ South End
¨ Back Bay ¨ Dorchester ¨ Mission Hill ¨ West End
¨ Beacon Hill ¨ East Boston ¨ North End ¨ West Roxbury
¨ Brighton ¨ Fenway-Kenmore ¨ Roslindale ¨ I live outside Boston:
¨ Charlestown ¨ Hyde Park ¨ Roxbury
¨ Chinatown ¨ Jamaica Plain ¨ South Boston
Applicant Contact Information:
Home Phone:
Cell Phone:
Email: / Additional Information:
Any other aspects of your identity you would like to share and feel could contribute to your or others’ InIt experience (e.g., sexual orientation, disability, immigrant status, etc.). Feel free to add an extra piece of paper if necessary:
Any special dietary, physical, or religious needs? (Note: this will not affect your acceptance into InIt):
Parent/Guardian Contact Information:
Full Name:
Home Phone:
Cell Phone:
Email:
Other Parent/Guardian Contact Information:
Full Name:
Home Phone:
Cell Phone:
Email:
How did you hear about InIt? ¨ YW Boston website/social media ¨ Friend/family ¨ Flyer
¨ InIt delegate (provide name): ______¨ Teacher: ______¨ Info session
2: References
Please list the names and contact information for 1-2 adults (who are not family members) who would be willing and able to speak about your character and fit for the InIt program. Examples include teachers, guidance counselors, youth group leaders, members of your religious community, neighbors, or work or volunteer supervisors.
Full Name / Phone Number / Email Address / Relationship To You3: Activities and Experience
On a separate piece of paper, please tell us about or outline the following items (a resume is acceptable):
· Activities you are or have been involved in at school or in the community
· Work or volunteer experience
· Leadership experience (can be formal or informal)
· Activities or interests involving social justice (can be the same as activities you have already listed)
· Anything else you want us to know about your activities and experiences
4: Personal Statement, Part A
In 1-2 paragraphs, please tell us why you are interested in participating in InIt and in what specific ways you think you will be a successful participant in this program. We want to know how you intend to be a committed participant and an effective leader in your school or community.
5: Personal Statement, Part B
Please complete one of the following:
1. In 2-3 paragraphs: What issues or conflicts in your school or community are most troubling to you that you want to see changed? What actions can you take to help make this change?
2. In 2-3 paragraphs: If you could create a club, lead a workshop, or give a presentation in your school or community to spark others’ interest in social justice issues, what would it be and why?
3. Attach a creative or artistic piece you created (such as a song, poem, visual art piece, etc.) that is related to a social justice issue(s) that impacts your life. Photos of visual art pieces may be sent in, as well as video/audio files of performances. Send creative or artistic pieces to Kaitlin at , with your name and indicating that you are submitting this as part of your application.
6: Student Signature
I certify that all of the information on this application is true.
Applicant signature: Date:
7: Parent/Guardian Statement of Commitment
My Child/Youth’s Name: ______
I understand that my child/youth is applying to participate in the Youth Leadership Initiative (“InIt”) program for 2017 – 2018. I understand that this is a program focused on social justice, diversity, and civic engagement that runs from August 2017 to May 2018.
I understand that, if my child/youth is selected to participate in InIt, they are required to attend an overnight retreat called “Immersion Week” from Monday, August 14 - Friday, August 18, 2017 at Camp Cedar in Casco, ME, as well as one Saturday Program Day each month from September through April and a graduation ceremony in May. In addition, InIt participants are expected to develop and complete a project during the program year through their school or host community organization.
I understand that there is a family/student tuition fee associated with InIt’s intensive 250+ hour leadership program.
Note: While we seek funding from a variety of sources, family fees play an important role in helping to sustain the program. Tuition contributions cover only a portion of the total cost per student, which includes accommodations and meals during the overnight retreat, monthly Program Days, and bi-weekly coaching and support throughout the academic year. If you have any questions or would like to discuss financial options, please contact Julia MacMahon at 617-585-5462. Need-based scholarships are available and family/student financial hardship does not prevent participation in the InIt program. Higher family contributions assist in covering other students’ need-based scholarships.
Family/Student Contribution per DelegateAnnual Household Income: / Less than $45,000 / $50
$45,001 - $57,500 / $250
$57,501 - $70,000 / $500
$70,001 - $82,500 / $750
$82,501- $95,000 / $1,000
More than $95,000 / $1,500
I understand that all tuition and contributions are non-refundable. I understand that all payments must be received before my child/youth starts the program in August, unless I have requested alternative payment arrangements. If my child/youth is accepted into the InIt Program, the portion of the tuition I/we will provide is $______.
I agree to help them actively participate in InIt in whatever manner is appropriate and necessary. This includes but is not limited to assisting them in making the necessary time, schedule, and transportation arrangements to participate in Immersion Week and the Saturday Program Days. I will support them in their leadership development and growth throughout the InIt year to the best of my ability.
Parent/Guardian Signature: ______Date: ______
An orientation session will be held at YW Boston on Thursday, July 27th, two to three weeks prior to Immersion Week, to provide additional information. If you have any questions in the meantime, please contact: Kaitlin Pang, InIt Recruitment Coordinator, at 617-585-5489 or .