2026 Public Good Generation Application

1

Student Name* This field is required.

First Name

Last Name

Suffix

2

Student Email* This field is required.

example@example.com

3

Parent/Guardian Name* This field is required.

First Name

Last Name

4

Parent/Guardian Email* This field is required.

example@example.com

5

What grade will you be in next year?* This field is required.

This program is open to rising juniors, seniors, and the graduating class of 2025.

6

What is your date of birth?* This field is required.

Date

7

What school do you attend?* This field is required.

8

If you attend a church, what church do you attend?* This field is required.

Can include "N/A" if you do not attend a church.

10

If you have a referral code, enter it here.

11

If you were referred by an individual, school or organization, enter their name here.

12

Please indicate how you will provide your video* This field is required.

Upload MP4 File

Provide Private YouTube Link

Email MP4 File

13

Why do you want to participate in this program? (Please provide your private YouTube link here.)* This field is required.

14

Why do you want to participate in this program? (Please upload your MP4 file here.)* This field is required.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

15

In what City and State do you live?* This field is required.

City

State

Country

16

Are you requesting a need-based financial scholarship for this program? * This field is required.

Yes

No