Clone of 2017 Youth Leadership Institute Application

2017 Youth Leadership Institute Application
Thank you for your interest in the Youth Leadership Institute.

Gwinnett SToPP is proud to include the Youth Leadership Institute (YLI) to our core community empowerment and change initiatives. YLI participants will also develop and work on a team project that lifts youth voice in education and builds a positive school climate.

Please read the entire application, completing each section in its entirety.

Why Participate in YLI?

The Youth Leadership Institute (PLI) is a unique experience pairing grassroots leadership training with education advocacy. YLI skill building components include finding and using your voice; relative, real, and responsible relationships; effective communication; mining social capital for future success; managing authority; the ins and outs of bringing about change; conflict management strategies; painting a picture of inclusion; anti-bullying /bias skills, are some of the leadership areas that our YLI participants will experience.

Upon graduation, participants benefit from a wealth of knowledge and resources resulting in heightened involvement and new associations in their school-community, which data shows, ultimately improves achievement and graduation rates for students. Students will also gain access to other national opportunites.

What does the program entail?

YLI includes a weekend retreat, monthly training sessions, independent homework assignments and a school-community project. Understanding the School to Prison Pipeline (STPP) - a national trend wherein students are funneled out of the regular education setting and into alternative education and the juvenile and criminal justice systems – is an integral part of the program. The YLI monthly training sessions are held primarily in Gwinnett County.

As a requirement of graduation, participants will be assigned to project teams to implement a school-community project designed to raise youth voice while impacting an STPP feeder, ultimately improving the school climate. Project results will be shared with school boards, public officials, and the community at large.

Who is involved?

Gwinnett Parent Coalition to Dismantle The School To Prison Pipeline (Gwinnett SToPP) is a grassroots, parent-led, community-centered organization in Gwinnett County. Members of the coalition, in addition to parents, include Atlanta Community Engagement Network (ACEN), Interfaith Children's Movement, and other community stakeholders. We are an active member of the Dignity in Schools Campaign (DSC) and regularly partner with other state and local organizations.
First, please tell us a little bit about yourself...
Full Name*

First NameLast Name
Preferred Gender Pronouns*

He, him, hisShe, her, hersThey, them, theirs
Date of Birth*

MonthDayYear
Race/Ethnicity*
Home Address*
City*
State*
County*
Zip Code*
Telephone*

Area CodePhone Number
Cell Phone*

Area CodePhone Number
Email*
Years at current address*
School Cluster*
If other, specify
If not Gwinnett, specify district and school
How or from whom did you learn about the Youth Leadership Institute?
Are you a student with disabilities?*

YesNo

Parent's Information
Mother's/Guardian Name*
Occupation
Cell Phone*

Area CodePhone Number
Email*
Home Address
Provide if different from Applicant
City
State
Zip Code
Father's/ Guardian Name*
Occupation
Cell Phone

Area CodePhone Number
Email
Home Address
Provide if different from Applicant
City
State
Zip Code

Community & Civic Involvement
Please list in order of importance to you, the top three community, civic, political, religious, social or other organizations that you have been actively involved (do not include business & professional activities.)
Organization
Position Held
Period of Service
Organization
Position Held
Period of Service
Organization
Position Held
Period of Service
Community Awareness
Name two challenges or opportunities that you see as being critical to the continued success of Gwinnett County Public Schools.
First
Second

	No	Yes
February 4 - Retreat Day 1 - Joined at the Hip and the Lip :Team Building Skills
February 5 - Retreat Day 2 - My Role, My Responsibility, My Reason
February 18 - ABC's of Discipline
March 4 - Discipline & The Courts
March 18 - Communicating Amongst the Trees
March 25 - Managing Conflict: Inside and Outside
April 15 - Youth in Action
April 29 - Graduation Luncheon

2017 Youth Leadership Institute Application

First, please tell us a little bit about yourself...

Parent's Information

Community & Civic Involvement

Community Awareness

Program Commitment

Tuition & Funding