2026 Summer Learning Institute Application
The Freedom House Summer Learning Institute (SLI) is an academic and enrichment program designed to empower City of Boston students through leadership development, community, and post-secondary exploration.
Student First Name
*
Student Last Name
*
Student E-mail
*
example@example.com
Student Mobile Number
*
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Birth Date
*
Please select a month
January
February
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Month
Please select a day
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Day
Please select a year
2026
2025
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Year
Gender
*
Please Select
Male
Female
N/A
Race/Ethnicity
*
Please Select
White
Black/African American
Asian
Middle Eastern
Latino/Hispanic
Native Hawaiian/ Pacific Isl
Social Security
*
High School
*
Current Grade Level
*
Please Select
8
9
10
11
12
BPS ID
How did you learn about Freedom House?
*
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Guardian Information
Please make sure you put accurate information.
Parent or Guardian Name
*
First Name
Last Name
Parent or Guardian Email
*
example@example.com
Parent or Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship to Student
*
Please Select
Mother
Father
Sibling
Aunt/Uncle
Legal Guardian
Grandparent
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Emergency Contact Information
If your parent/guardian is your emergency contact, you can skip.
Emergency Contact
First Name
Last Name
What is their relationship to you?
(i.e. mother, father, uncle, aunt, brother, sister, grandparent, mentor , etc)
Emergency Contact Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
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Academic Support
Current GPA
*
Are you on an IEP/540 plan or receiving special education services?
*
Yes
No
Have you/your scholar ever been diagnosed with a mental health condition?
*
Yes
No
Preferred learning style or support needed:
High School Seniors or Graduates only: What are your goals for after graduating High School?
Attend a 2 year or 4 year college/university
Attend trade school or academy (Police, Firefighter, etc)
Immediately get a Full Time or Part Time job
Take a gap year (Time between high school graduation and college)
Not sure
Are you a High School Senior or Graduate that needs support with your post secondary goals whether that is college, trade school, or into the workforce?
*
Yes I am
Yes I am but I do not need support
No
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Transport and Access
It is important to have reliable transport to program and be on time. We ask you arrive 10 minutes early before your work time to get settled.
Method of Transport to Freedom House
*
MBTA
Own a Vehicle
Parent
Friend/Other Parent
Access to internet/Wifi for emails and text from Freedom House:
*
Yes
No
You are required to be onsite for work Monday-Thursday from 1:00pm-5:30pm (10:00am if you have enrichment). Are you involved in another program, job, sport, or school activity that would prevent you from bring on time or attending 4 days a week? If yes, explain.
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High Risk Activity Background and Support
These questions aim to gather information about your past experiences with legal systems, social services, and high-risk behaviors to help us better understand your background and any support you may have received. The questions are designed to ensure that we provide appropriate services and resources tailored to your needs. Please answer the questions openly and honestly, as this information will remain confidential and used solely to support your journey in the program. Please answer "Yes or No".
Have you ever been involved with the court system, social services (e.g., DSS/DCF), or participated in high-risk behaviors (e.g., substance use, gang affiliation)?
*
Yes
No
Have you ever been involved with the court system, either through juvenile or adult proceedings? If yes, please provide a brief description of your involvement (e.g., type of case, outcome).
*
Are you currently or have you ever been involved with the Department of Social Services (DSS) or the Department of Children and Families (DCF)? If yes, please explain your involvement and any support you are receiving.
*
Do you engage in or have you ever participated in high-risk activities such as substance use, gang affiliation, or any other behaviors that could impact your personal safety or well-being? Please provide details if applicable.
*
Have you ever received support or been referred to any programs due to involvement in high-risk behaviors (e.g., counseling, mentoring, probation, or other intervention services)? If yes, please specify.
*
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Morning Enrichment Survey
Please select up to 2 options.
I will have credit recovery (summer school)
I would like to take college class at RCC
Next Moves Only: Vision, Goals, and Your plans after High School (Seniors/Graduates)
Freedom House Sound Lab: For students ready to perform whether you play, sing, or speak.
Mental Health Workshop (Facilitator TBD)
Entrepreneurship
Pilates
None (Your day will start 1:00pm sharp)
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SLI Summer Attendance Policy & Commitment Agreement
Parent/Guardian Signature
*
Student Signature
*
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