Presente Application

1
Name* This field is required.
First Name
Middle Initial
Last Name
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Date of Birth* This field is required.
Date
Month
Day
Year
3
Today
Date
Month
Day
Year
4
Age
5
What gender do you identify with?* This field is required.
Female
Male
Other
6
What is your race? (Select all that apply)* This field is required.
American Indian or Alaska Native
Asian American/ Pacific Islander
Black or African American
Hispanic, Latino, or Spanish
White
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Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
8
Phone Number* This field is required.
Please enter a valid phone number.
9
Email* This field is required.
example@example.com
10
Parent(s)/Guardian(s) Information* This field is required.
First Name
Last Name
Phone Number
Email
2nd Parent/Guardian First Name
2nd Parent/Guardian Last Name
2nd Parent/Guardian Phone Number
2nd Parent/Guardian Email
11
Education* This field is required.
Please Select
Please Select
High School
College
Level of Education
Name of High School/College
Please Select
Please Select
Yes
No
Did you graduate?
12
What year did you graduate?* This field is required.
13
What is your current grade level?* This field is required.
Freshman
Sophomore
Junior
Senior
14
How have you stepped into your power since completing the Presente Fellowship? Share a moment when you turned what you learned into real action or leadership.* This field is required.
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In what ways have you continued to uplift your community or stand up for what matters to you? What drives your passion to make a difference?* This field is required.(Your culture/country/nationality/ethnicity/race/gender/physical ability or sexual orientation)
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Tell us about a bold step you’ve taken to create change big or small. What inspired you, and how did it shape your growth?* This field is required.
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What dreams or goals are you currently chasing, and how does this internship fit into your larger vision for yourself and your community?* This field is required.
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Presente Alumni lead by example. How would you use your voice, experience, and strength to support other youth and be a force for positive change?* This field is required.
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If you had the resources to launch a movement, initiative, or campaign to address one issue in your community, what would it be and why does it matter so deeply to you?* This field is required.
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Disclaimer & Signature* This field is required.I certify that my answers are true and complete to the best of my knowledge. If my nomination is accepted, I understand that false or misleading information in my application or interview may result in my disqualification or release from the Fellowship Program.
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Parent Signature & Disclaimer* This field is required.If you’re a minor, please provide parent/guardian signature I certify that my answers are true and complete to the best of my knowledge. If my nomination is accepted, I understand that false or misleading information in my application or interview may result in my disqualification or release from the Fellowship Program.
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