Georgia State Leap Year Fellow Application
Please complete this form to apply to the GSU Leap Year Fellowship. Learn more about the program at www.leapyearfellows.org.
Full Name
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First Name
Last Name
Birth Date
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-
Month
-
Day
Year
Date
Current Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What High School do you attend?
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What year will/did you graduate from high school?
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Class of 2021
Class of 2022
Class of 2023
Class of 2024
What is your GPA?
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Did you participate in an IEP program in high school?
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Yes
No
Which of the following aligns best with your goals after graduation?
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I'm not interested in going to college, I want to join the workforce.
Trade Certificate (1-year diploma ex. cosmetic, electrical, hair, automotive, etc.)
Associates Degree (2-year degree ex. GSU Decatur, Atlanta Metro, etc.)
Bachelor's Degree (4-year degree ex. GSU Downtown, Clark Atlanta, etc.)
I am unsure about going to college (I am not committed to college, I have an interest in college and would like to try it out, etc)
Please explain why you are unsure about college. (Financial reasons, overwhelmed by college admission process, lack of support from family, etc.)
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Have you applied to or been accepted into Georgia State University?
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Not yet applied to GSU
Applied to GSU but not yet accepted
Accepted into GSU Perimeter
Accepted into GSU Downtown
Have you taken college level English 1101 for credit?
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Yes
No
Please list all the college classes you have taken for credit below.
*
Have you completed FAFSA?
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Yes
No
Are you a US citizen?
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Yes
No
Other
How do you identify?
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Female
Male
Nonbinary
Other
How do you identify?
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Black/African American
Latinx/Hispanic
Asian
Native American
White
Other
Are you a first-generation college student (ie neither of your parents completed a bachelor's degree)?
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Yes
No
Have you or your family participated in any of the below programs in the last three years?
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SNAP/Food Stamps
Free and Reduced Lunch
Section 8
Social Security Disability
Medicaid
None of the above
Are you a parent?
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Yes
No
Why do you want to be a Leap Year Fellow? What do you hope to gain from the program? Be sure to write in complete sentences.
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Please choose one of the following for your interview!
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Virtual Interview (Choose if you would like to receive a link to a virtual interview)
In-Person Interview (Choose if you are at school with a Leap Year representative who can interview you today!)
Set your Virtual Group Interview
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Please verify that you are with a Leap Year representative who has agreed to interview you in-person today.
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Yes, I am with a Leap Year representative who has said he/she will interview me today.
Email Address:
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example@example.com
Cell Phone Number
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Please enter a valid phone number.
IMPORTANT: Your virtual interview will take place on ZOOM at the time you selected above. The Zoom link will be EMAILED to you later this week. Be sure to check your Spam folder just in case. Is the email address you provided above your correct email address?
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Yes, and I will check my email for the interview link next week
No, I need to provide a different email address
Did you participate in any of the following programs?
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Next Generation Men/Women
College AIM
OneGoal
Communities in School
Boys and Girls Club
Big Brothers Big Sisters
None of the above
Other
How did you hear about Leap Year?
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Do you have any questions about the Georgia State University Leap Year Fellow program?
Submit
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