Anytown Leadership Institute 2023 Application

Anytown Leadership Institute 2023 Application

This year's program will be held Sunday, July 16 - Saturday, July 22 at Oklahoma State University in Stillwater. Attendance for the full program is required. Please note that the application can be saved and completed at the applicant's own pace. To do this, please scroll to the very bottom of the embedded form, click "SAVE" and follow the pop-up instructions.
About You!
Name*

First NameLast Name
she/hershe/histhey/theirsOther
Date of Birth*

MonthDayYear
Date
AfricanAfrican American/BlackAsian/ Asian AmericanBiracialHispanic/LatinxNative/ IndigenousWhite/ European descentOther
Race or Ethnicity 2*
ex. Nigerian, Hmong, Irish, Vietnamese, Puerto Rican, etc.
FemaleMaleNon-binaryGenderfluidOther
BuddhismCatholic ChristianHinduJewishMuslimNative/Indigenous Traditional LifewaysNoneProtestant ChristianUnitarian UniversalistOther
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
High School*
Expected Graduation Year*
SmallMediumLargeXLXXLXXXL
How did you find out about Anytown?*
Are you related to an Anytown alumni? If so, please list the person's name and their relation to you. *
About Your Parent/Guardian
Parent/Guardian Full Name*

First NameLast Name
Parent/Guardian Phone*
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Email*
example@example.com
YesNo
Short Answer Questions

Please respond to the prompts below in 1-2 sentences.
Please list the leadership activities (sports, clubs and/or faith based youth groups, etc.) you are involved in. *
How do you define leadership?*
Who inspires you? Why?*
What do you do for fun?*
What's something you're most proud of? Why?*
How would one of your teachers describe you?*
What are your "next steps" and/or plans after high school?*
Let's say you are asked to choose between pancakes and waffles...but with high stakes. The one you do not choose is wiped from existence forever. Which do you choose and why?*
Long Answer Questions

Please respond to the prompts below in 4-5 sentences.
What most excites you about participating in Anytown this year?*
Describe an experience you have had where more skills or knowledge related to leadership, inclusion or cultural awareness would have been helpful to you. *
How have you been a leader or displayed leadership skills or abilities at home, in your school or in your community?*
If you could instantly change anything in your school or community, what would it be and why?*
Please upload your recommendation letter here.

You must submit one letter of recommendation. This can be written by an adult supervisor of a leadership activity you are involved in, just remember to list that activity on this application!
Cancelof
Scholarship Application

The total cost of attending Anytown is $450. OCCJ would like to support all youth considering our program and do not want cost to be a barrier to anyone's participation. Full and partial scholarship assistance is available. If you are interested in receiving a scholarship, please complete the section below in full.
Please note the family income per month.
Please list all individuals in your household. Include name, age, relationship to you (the applicant), occupation, and school attended.
Scholarship amount requested.
Please note: Total cost of the program is $450 with payment due in full on July 16. If you receive a scholarship, the amount you request will be deducted from the total due.
Are there any circumstances we should be aware of that might warrant special consideration for financial assistance? If so, please explain:
Thank you!
Applicants will begin recieving notice of their acceptance by April 1st on a rolling basis! If you have any questions about Anytown 2023 before then, please contact OCCJ Programs Director, Cara Golden at cgolden@occjok.org.

Thank you for applying!
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Anytown Leadership Institute 2023 Application

About You!

About Your Parent/Guardian

Short Answer Questions

Long Answer Questions

Scholarship Application

Thank you!