ACHIEVER PROGRAM APPLICATION

ACHIEVER PROGRAM APPLICATION

2026 Cohort
Please use this form to submit your application to the Achiever Program. Please answer all questions completely with as much detail as possible when completing this application. When appropriate enter "N/A" for any question that doesn't apply to you.

A 2.5 G.P.A. is required to participate in the program. A transcript with grades reflecting coursework through second semester junior year must accompany the application. A reference letter is also required to support your application.

Applications are due by Sunday, October 12, 2025 at 11:59PM PST

For further information OR support:

Anjetta Bowles Phone: (323) 559-2573

Dr. La Shawn Witt Phone: (310) 357-9715

Email: acachieverprogram@gmail.com
Candidate Name*

First NameMiddle NameLast Name
Email*
example@example.com
Phone Number*
T-Shirt Size*
Shoe Size*
1. Parent/Guardian Name*

First NameLast Name
Address of Parent/Guardian 1*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
1. Parent/Guardian Phone Number *
Please enter a valid phone number.
1. Parent/Guardian Email Address*
example@example.com
2. Parent/Guardian Name

First NameLast Name
2. Parent/Guardian Name

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
2. Parent/Guardian Phone Number
Please enter a valid phone number.
2. Parent/Guardian Phone Number
example@example.com
High School *
High School Awards/Leadership Positions *
School Activities and Organizations *
Community Activities and Organizations *
Future Career/Professional Plans*
Hobbies and Interests *
Special Talents *
Work Experience *
Employer
Employment Dates
Do You Live With (Check all that apply)*

MotherFatherGrandparent(s)Other RelativeGuardian
Do you have a relative that is an Angel City Link Alumni Achiever?*

YesNo
If Yes, enter the name of the Achiever and the year of his participation
Do you have additional relatives who are Alumni Achievers?*

YesNo
If Yes, How many?
Are you interested in applying for a "financial needs based" scholarship? (Tax year ending 2024 annual family adjusted gross income will be less than $60,000.00)*

YesNo
Dates you may be unavailable for program activities due to Prom
Dates you may be unavailable for program activities due to Graduation
Dates you may be unavailable for program activities due to Testing
Dates you may be unavailable for program activities due to Spring Break
Do you have any other Saturday/Sunday commitments that may conflict with Achiever Program activities?*

YesNo
If Yes, please detail events and dates
Please upload a professional headshot.

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Upload School Transcript (Official OR Unofficial)

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Upload Letter of Recommendation (This letter can also be submitted electronically with the link you will receive via email acachieverprogram@gmail.com)

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