The Beloved Community Leadership Academy 2022 Cohort

The Beloved Community Leadership Academy

Official Student Application
The King Center is proud to present our Beloved Community Leadership Academy. Our mission is to empower "DREAM Builders"(youth and young adults ages 13-18), to create a just, humane, equitable, and peaceful world by applying Dr. King's nonviolent philosophy and methodology through modern-day innovation. Please complete the application below. Please email all questions, comments and concerns to our admin team at leadershipacademy@thekingcenter.org.
Student Last Name *
Student First Name *
Student Middle Initial *
Student's Ethnicity *

American Indian/Alaskan Native Asian/Pacific Islander Black/African American Hispanic White Middle Eastern Two or More Races Prefer not to say Other
Are you proficient in the English language? *

Yes No
Student's Gender *

Female Male Non-binary Prefer not to say
Student's Birthday *

Month Day Year
Date
Student Phone Number *
Student Email Address *
example@example.com
Student's School *
Student's Age *

13 14 15 16 17 18
Student's Grade Level *

07 08 09 10 11 12
Student's T-Shirt - Size *

XS S M L XL XXL
Student's GPA *
Student's Street Address *
City *
State/Province *
Country *
Postal Code *
Parent / Legal Guardian Last Name *
Parent / Legal Guardian First Name *
Parent / Legal Guardian Phone Number *
Parent / Legal Guardian Email Address *
example@example.com
Please share the name of the organization or individual who referred you.
This program requires virtual live session which are held M-F from 10-3PM EST during the summer and weekly on Tuesdays at 7PM EST during the Fall and Spring. Please agree to attend. *

I agree
This program requires a 15-month commitment. Please agree to attend. *

I agree
Would you like to be considered for a scholarship? *

Yes No
This newly established Beloved Community Leadership Academy is launched in partnership with Goldman Sachs One Million Black Women, an initiative focused on narrowing the opportunity gap for Black women and girls with the goal to positively impact the lives of one million Black women over the next 10 years. One Million Black Women will provide scholarships to deserving Black girls and will support a dedicated cohort of One Million Black Women scholars. If you are interested in applying to participate in this cohort, please complete the related questions below.
Share an example of a time where you served as a leader at your school, among your friends or in our community. [We’re looking for all different types of leaders and appreciate leadership can take many forms, like caring for your younger siblings or starting a new club for other kids in your neighborhood.] (500 characters) *
Who is a leader you admire? Why? (500 characters) *
Finish this sentence, offered by Organizer and Social Justice Leader Samantha Master, “I dream of a world where Black girls…”(Max: 100 characters) *
As part of the OMBW cohort, we will offer special sessions on Saturdays with guest speakers, including leaders across entertainment, finance, tech, the arts, and social justice. Are you willing to commit to an additional Saturday session each month during your participation in this program? *

Yes No
What would you like to learn about in these OMBW Saturday sessions? (Max: 200 characters) *
Do you need any specific accommodations in order to participate in this program? *

Yes No
If yes, please explain. *
Scholarship Level *

Full Partial
Scholarship Type *

Merit Need
Household Income *

$0-$25,000 USD $25,000-$50,000 USD $50,000-$75,000 USD $75,000-$100,000 USD $100,000-$150,000 USD $150,000-$200,000 USD $200,000-$250,000 USD $250,000+
Free or Reduced Lunch *

Yes No
To participate in a virtual program, you will need access to a computer. Do you have access to a laptop, tablet and/or computer? *

Yes No
To participate in a virtual program, you will need access to the internet. Do you have access to an internet connection or hotspot? *

Yes No
Will you commit to turning your camera on during each session? *

Yes No

How interested are you in the following? *

	Not Interested	Interested	Very Interested
Video Gaming
Video Podcasting
Art and Design
Building Mobile Applications
Entrepreneurship
Leadership
Peacebuilding
Social Justice
Business
Nonviolence

School Involvement *

Very Involved (10+ Hours per week) Involved (5-9 Hours per week) Somewhat Involved (2-4 Hours per week) Not Involved (0-1 Hour per week)
Community Service *

Very Involved (10+ Hours per week) Involved (5-9 Hours per week) Somewhat Involved (2-4 Hours per week) Not Involved (0-1 Hour per week)
Please upload your most recent report card

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Please upload letter of recommendation (Nomination email sufficient)

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Have you previously participated in CAMP NOW or another youth program at The King Center? *

Yes No
If so, please describe. *
Personal Essay: Why do you want to attend the Beloved Community Leadership Academy? (500 characters) *
Personal Essay: What do you hope to learn and/or accomplish as a participant in the Beloved Community Leadership Academy? (500 characters) *
Signature:(Parent / or Legal Guardian Signature required if applicant is under 18): *

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