C2027 LYF Application- 9.10.25

Georgia State Leap Year Fellow Application - FINAL

Please complete this form to apply to the GSU Leap Year Fellowship. Learn more about the program at www.leapyearfellows.org. Note: All Accepted Applicants are required to Apply to Georgia State Perimeter.
To be considered, you must complete this form in full. All applicants who complete an interview will be considered for the 2026–2027 Cohort. We’re excited to learn more about you! If you have any questions, don’t hesitate to reach out.

Email: Recruiter@theleapyear.org, Phone: 470-377-1473
Full Name*

First NameLast Name
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Birth Date:*

MonthDayYear
Age:*
Email Address:*
Cell Phone Number:*
IMPORTANT: Please carefully enter your phone number- this is how we will communicate with you.Format: (000) 000-0000.
What high school do you attend?*
What high school do you attend?*
Which district is your high school?*

Atlanta Public SchoolsDekalb County Public SchoolsFulton County Public SchoolsOther
What year will/did you graduate from high school?*

Class of 2023Class of 2024Class of 2025Class of 2026Class of 2027Other
What is your GPA?*
If you don't know, just put what it was on your last report card.
Did you participate in an IEP program in high school? If you do not know what an IEP is than put "No".*

YesNo
Please provide information about your IEP Program. *
Why do you want to be a LYF? Rank order from the main reason to the smallest reason:*
If you had another reason for joining not listed above, please specify:*
What do you plan to do after graduation?*

I'm not interested in going to college, I want to join the workforce.Trade Certificate (1-year diploma ex. plumbing, cosmetic, electrical, hair, auto, etc.)Associates Degree (2-year degree ex. GSU Decatur, Atlanta Metro, etc.)Bachelor's Degree (4-year degree ex. GSU Downtown, Clark Atlanta, etc.)I am unsure about going to college (I am interested in college and would like to try it out but I am not fully committed to college)
Have you applied to or been accepted into Georgia State University?*

Not yet applied to GSUApplied to GSU but not yet acceptedAccepted into GSU PerimeterAccepted into GSU Downtown
Have you taken or are you in the process of taking a college level course for credit? (i.e. English 1101, Math 1001, Math 1111, English 1101, English 1102, Math 1001, Math 1111, US History 2110, etc.)*

YesNoOther
Please list all the college classes you have taken or plan to take for credit below.*
Thank you for your interest in Leap Year! Unfortunately, if you are an applicant who has already taken English 1101, English 1102, Math 1001, Math 1111, or US History 2110 you do not qualify for the Leap Year program.

Please see the Leap Year FAQ Page (leapyearfellows.org/faq-3/) or Contact Us: (Recruiter@theleapyear.org) if you have any questions!
Are you a US citizen?*

YesNoOther
How do you identify?*

FemaleMaleNonbinaryOther
How do you identify?*

Black/African AmericanLatinx/HispanicAsianNative AmericanWhiteOther
Are you a first-generation college student (i.e. neither of your parents completed a bachelor's degree)?*

YesNo
Have you or your family participated in any of the below programs in the last three years?*

SNAP/Food StampsFree and Reduced LunchSection 8Social Security DisabilityMedicaidNone of the above
Check all that apply to your situation:*

I am responsible for helping my family pay bills (ex rent, utilities, etc.).I am responsible to taking care of my siblings.Going to college is most important to me right now.Making money is most important to me right now.I have my own car.I think community service is important.
Do you currently live with:*

I live with my parent(s).I live with my grandparent(s).I live with other family members.I live with my friend(s).I do not have a steady place to live.Other
Are you a parent or expecting to have a child within the next 9 months ?*

YesNo
How did you hear about Leap Year?*

Leap Year RecruiterInfo Session (ex: Classroom Presentation, Town Hall, etc.)College Advising CorpsCollege AIMHigh School CounselorTabling Event (ex: College Fair)Next Gen Men/WomenCommunities in SchoolMentorFriendOther
If you heard about us from a counselor/friend/mentor, what's their name? If not, put NA.*
Sign-up for an Interview

To be considered for Leap Year, you MUST complete an interview. Interviews start in December and will happen at your school or on Zoom. We will reach out when it’s your turn—so it’s very important that you check your email and text messages often so you don’t miss your spot! Please note that the last interview is scheduled for May 4th digitally and anyone who fills out an application after April 28th will automatically be signed up for an interview on Monday, May 4th at 5 pm.
I understand that I MUST complete an interview to be considered for the Leap Year program.*

Yes
Do you have any questions about the Georgia State University Leap Year Fellow program?
By submitting the Leap Year Application, you agree to receive text messages and emails from Leap Year.

You will have the option to opt-out or unsubscribe from the text messages and emails if you wish to do so.
Should be Empty:

Georgia State Leap Year Fellow Application - FINAL

To be considered, you must complete this form in full. All applicants who complete an interview will be considered for the 2026–2027 Cohort. We’re excited to learn more about you! If you have any questions, don’t hesitate to reach out.

Thank you for your interest in Leap Year! Unfortunately, if you are an applicant who has already taken English 1101, English 1102, Math 1001, Math 1111, or US History 2110 you do not qualify for the Leap Year program.

Sign-up for an Interview

By submitting the Leap Year Application, you agree to receive text messages and emails from Leap Year.