Participant Application: Emotion Revolution Summit (October 24Th, 2015 * New Haven, CT)

Participant Application: Emotion Revolution Summit (October 24Th, 2015 * New Haven, CT)

Participant Application: Emotion Revolution Summit (October 24th, 2015 * New Haven, CT)

We are excited to launch the Emotion Revolution, a joint initiative between theYale Center for Emotional Intelligence and Born This Way Foundation to build awareness around the critical role of emotions in learning, decision-making, and both student and educator wellness and effectiveness. To attend the Emotion Revolution, please complete this application and return to y Saturday, August 1st, 2015.

  • Applicants must currently be enrolled in high school (or equivalent program) within the United States.
  • Applicants must have the recommendation of a teacher or administrator from their school.
  • There are limited scholarships available; travel and accommodations (if needed) in New Haven are the responsibility of the student.
  • Applicants under 18 years of age will be required to list an Emergency Contact below + submit additional information.

Applicant Personal Information:

Name: Age:

High School: School Year:

Mailing Address:

City: State: Zip Code:

Email Address: Cell Phone #:

Twitter Handle: Instagram Handle: Blog/Tumblr:

Extracurricular Activities/Clubs/Positions:

Emergency Contact (Parent/Guardian)

Name:Relationship:

Phone #: Email:

Teacher/Administrator Recommendation:

Recommender Name: Position:

Email Address:Phone #:

Please attach/include a statement of less than one page on why the student above should be selected to represent your school and study body at the Emotion Revolution in October 2015. Statements can be attached to this application or sent directly to ith the student’s name referenced in the subject line.

Narrative Questions: Please Limit Responses to 1,000 Words Total

  1. Why do you want to attend the Emotion Revolution and what do you believe you can uniquely contribute to the task of building a positive climate in your school and beyond?
  1. Please tell us about a time that you exhibited leadership characteristics in your school, home or community.
  1. Please share your thoughts on why young people today are reporting feeling greater levels of stress than in the past and what you believe teachers, administrators and students can do to combat those increased levels of stress?

Miscellaneous Information:

  • Will You Need A Scholarship?Y N If Y, Which One? TravelAccommodation Both
  • Send Application Information To My Friends (Include Contact Information Below)

Name:Email Address:Phone #:

Name:Email Address:Phone #:

Name:Email Address:Phone #:

Top View