Muhammad Ali Center Youth Programs Application Form 2023-2024

Muhammad Ali Center Youth Programs Application

For over a decade the MAC has cultivated the next generation of social justice leaders through our comprehensive high school leadership development programs. The Muhammad Ali Center Council of Students (MACCS) is a social justice, leadership development and service-learning program where students explore strategies for social change, leadership skills, and social justice issues. UCREW offers a unique opportunity for students to learn about social entrepreneurship. By the end of the program, students will have conceptualized, produced, marketed, and launched a small social enterprise business. These year-round, leadership programs serve 100 students annually.
Application Deadline - August 14, 2023 @ 11:59PM
Which program are you signing up for? (Choose one option)*
BASIC INFORMATION
Student's Full / Legal Name*

First NameLast Name
Preferred Name
Pronouns*
2023-2024 High School*
2023-2024 Grade Level*
Student Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Student Cell or Primary Phone Number*

Area CodePhone Number
Student E-mail*
Student Birth Date*

MonthDayYear
Student T-Shirt Size*
Parent or Guardian Full Name*

First NameLast Name
Parent or Guardian E-mail*
example@example.com
Parent or Guardian Phone Number*

Area CodePhone Number
Secondary Parent or Guardian Full Name

First NameLast Name
Secondary Parent or Guardian E-mail
example@example.com
Secondary Parent or Guardian Phone Number

Area CodePhone Number

Short Essays:

In this section, we would like to get to know you. What do you care about? When you look around at our community, nation, and world, what bothers you? What would you change? Why do you want to be a part of Muhammad Ali's legacy? We care more about your ideas than your writing style but your answers should be at least a paragraph long.
What social issue do you care about? What change would you like to see in your community, nation, or world?*
Choose one of Muhammad Ali's 6 Core Principles and tell us how that principle has played a role in your life (Confidence, Conviction, Dedication, Giving, Respect, Spirituality).*
Please describe an area of personal growth that you intend on being positively impacted by your participation in our youth programs. *
REFERENCES:

Please list one educator or community member who would recommend you to the Muhammad Ali Center. Please do not list relatives or persons living in your household. If you have been referred by a current or graduated MACCS student, please list that individual below.
Reference 1 Name (Position,Phone Number)*
MACCS/UCREW referral (if you have been referred by a current or past MACCS or UCREW student, please indicate below)
SCHOOL / COMMUNITY ACTIVITIES / WORK / EXPERIENCE/SPORTS/AWARDS/ETC:

Please tell us how you are currently involved in your school and community. You DO NOT need to fill in every blank.
School Activities / Offices Held: (not sports)
Volunteer Activities
Sports Participation
Travel Experience or Unusual Experiences (study abroad, etc.)
School / Community Awards and Honors 1 (no matter how small) CSF, GSE, National Honor Society, Girl/Boy Scouts, 4-H, Governor’s Scholar, etc.
EMPLOYMENT 1: List past and present work and length of time employed.
Internships: List past and present internships.

Muhammad Ali Center Youth Programs Application

Application Deadline - August 14, 2023 @ 11:59PM

BASIC INFORMATION

Short Essays:

REFERENCES:

SCHOOL / COMMUNITY ACTIVITIES / WORK / EXPERIENCE/SPORTS/AWARDS/ETC:

Demographic Information:

Dedication: