Future Leaders Initiative: Participant Application

Future Leaders Initiative: Participant Application
Please complete and submit this form by Tuesday, Nov. 25 at 11:59 p.m. Selected applicants will be notified by Tuesday, January 6.

For questions, contact: futureleaders@scag.ca.gov

Disclaimer: Your responses will be kept confidential, to the extent allowed by law, and reported only in aggregate form. Individual responses will not be shared publicly, and no personally identifying information will be included in reports. SCAG complies with the California Public Records Act and federal nondiscrimination laws, including Title VI of the Civil Rights Act.

Section 3: Commitment & Access
14. Do you have access to a device and internet to participate in virtual sessions?

YesNo

This program includes sessions that build upon lessons and information from previous sessions. The schedule is as follows:

Date	Time	Format
Jan. 22	3-5 pm	Virtual
Feb. 26	3-5 pm	Virtual
March 26	3-5 pm	Virtual
April 23	3-5 pm	Virtual
May 21	3-5 pm	Virtual
June 17	10:30 am-1:30 pm	In-Person @ SCAG Headquarters in downtown Los Angeles

15. Will you commit to attending one virtual, two-hour session per month, from 3 to 5 pm on the days above, and one in-person session, to be held at the SCAG office in downtown Los Angeles, for the culmination of the program?*

YesNo I anticipate a conflict and would like to discuss—please explain:

Section 4: Demographic (Optional)
Your participation is voluntary. This information helps SCAG ensure programs are equitable and comply with civil rights laws. Your responses will be kept confidential and reported only in aggregate form.
16. Are you between the ages of 18 and 26?

YesNo
17. Race/Ethnicity:
18. Gender Identity:
19. Preferred Language(s):
20. Do you identify as a first-generation college student?

YesNoN/A
In accordance with the Americans with Disabilities Act (ADA), SCAG provides accommodations for persons who require them to participate in public meetings. SCAG also provides translations of its documents upon request in accordance with Title VI. Both services can be requested with at least 72 hours (three days) notice in advance of the meetings by calling (213) 236-1895.
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Application Form