Youth Leadership & Civic Engagement Program Application Riverside, CA

Please submit this form and a copy of your resume to ItaliaG @MiFamiliaVota.org with the following subject line: “LastName FirstName – Youth Leadership Application”

If you have any questions or comments feel free to contact us at ItaliaG @MiFamiliaVota.org .

Personal InformationName:Date of Birth (MM/DD/YYYY) :Gender:

Home Address: City: State:ZIP Code:

Cell Phone Number:May we text you information & updates? Y / N

Main Email (most checked):

High School or College Name:Year in School (ex: “High School Junior” or “2nd year college”):

Are you a first generation college student?

What is the primary language spoken in your home?

What country were you born in? (ex: “Honduras” or “U.S.”)

Do you commit to meet on a regular basis (mostly on Saturdays once or twice a month) during the Youth Leadership and Civic Engagement Program?

Personal Questions (1-2 Sentences)

1. Describe your ethnic and cultural background.

2. Describe your career/academic interests.

3. What social issues are you most passionate about?

4. Define your mission statement.

Youth Leadership & Civic Engagement Program Application Riverside, CA

Short Essay Questions (150 Words - 200 Words)

1. Do you think the Latino community is important to the future of your city and state? Why or why not?

2. If you could change one thing about your community or environment that affects your family, what would it be?

3. Tell us about a moment, activity, or award of greatest importance to you, and how you used a personal strength to accomplish it.