SIGMAPAC 1914 | JOHN R. LEWIS POLITICAL LEADERSHIP BOOT CAMP Application Form

SigmaPAC 1914 | 2024 John R. Lewis Political Leadership Boot Camp Application
Read and follow the instructions carefully prior to submitting your application. Only application submitted using Jotform will be considered. Two participants will be selected from each region. Final submissions are due March 10, 2024. All winners will be notified on or before March 31, 2024.

If selected, you may be asked for documentation to support the data you provide. Likewise, all correspondence and award agreements will be generated from the personal information submitted below. So, please use proper spelling, capitalization and punctuation.

Learn more at thesigmapac1914.org. If you have any questions, please email frederick@frederickbell.org. (Do not send application materials to this email address).
I. Personal Data

Tell us about yourself
Full Name*

First NameLast Name
Mobile Number*
Email *
Where the confirmation will be send to
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are you a financial member of Phi Beta Sigma Fraternity, Inc.?*

YesNo
Which region are you a member in?*

EasternGreat LakesGulf CoastSoutheasternSouthernSouthwesternWestern
Current Chapter *
Tell us about yourself. What experiences or personal background have shaped your interest in politics or social activism?*

0/250
How would you describe your involvement in community or political activities until now?*

0/250
What do you perceive as the most pressing political or social issues in your community or the wider world today?*
What drives your interest in participating in the John R. Lewis Political Leadership Boot Camp?*

0/250
How do you envision using the knowledge gained from this boot camp to address these issues?*

0/250
For Students Currently Enrolled
Institution Name
Major/Focus
Cumulative GPA
Major GPA
Activities, honors, offices held, etc. (School-related or otherwise)*
Essay
What does "Good Trouble" means to you?
Essay*

0/500
Applicant's E-Signature
By signing the space below, you are certifying that all information is correct and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application.
Signature*

Clear
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SigmaPAC 1914 | 2024 John R. Lewis Political Leadership Boot Camp Application

I. Personal Data

For Students Currently Enrolled

Essay

Applicant's E-Signature