The Beloved Community Leadership Academy Application

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 NativeAsian/Pacific IslanderBlack/African AmericanHispanicWhiteMiddle EasternTwo or More RacesPrefer not to sayOther
Student's Gender*

FemaleMaleNon-binaryPrefer not to say
Student's Birthday*

MonthDayYear
Date
Student Phone Number*
Student Email Address*
example@example.com
Student's School*
Student's Age*

131415161718
Student's Grade Level*

070809101112
Student's T-Shirt - Size*

XSSMLXLXXL
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 an in person session weekly, Community Action Project and possible virtual sessions. Please agree to attend.*

I agreePlease add your preferred day of in person attendanceOther
This program requires a 12-month commitment. Please agree to attend.*

I agree
Do you need any specific accommodations in order to participate in this program?*

YesNo
If yes, please explain.*
To participate in a virtual program, you will need access to the internet. Do you have access to an internet connection or hotspot?*

YesNo
Will you commit to turning your camera on during each session?*

YesNo
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)
Have you previously participated in NextGen, CampNOW, BCLA EmpowHER or another youth program at The King Center?*

YesNo
If so, please describe.*
Personal Essay: Why do you want to attend the Beloved Community Leadership Academy? (500 characters)*
Personal Essay: How are you a leader? (500 characters)*
Personal Essay: Why is nonviolence an important aspect to your life and society? (500 characters)*
Personal Essay: Why is community service important to you? Please explain your community service experience. (500 characters)*
Personal Essay: What do you hope to learn and/or accomplish as a participant in the Beloved Community Leadership Academy? (500 characters)*
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