STUDENT APPLICATION FORM

The Andrew Young Emerging Leaders Institute

The Andrew Young Emerging Leaders Institute was created to assist students at Historically Black Colleges and Universities in developing and/or honing their leadership skills with emphasis on understanding some of the entrepreneurial, social, technological, economic, environmental and political trends and events that are likely to occur over the next 20 years and the impact that these trends and events may have on their livelihood.

QUESTIONS? Contact Merral Jackson at mjackson@twd-inc.net
*Applicants under the age of 18 must have parental consent.

PERSONAL INFORMATION:

Applicant Name *

DOB *

Gender *

Address *

City *

State *

Zip Code *

Mobile No.

Home Phone No.

Email Address *

SCHOOL INFORMATION:

School

Major

Graduation Year *

Classification in Fall

GPA *

Leadership Role(s) on Campus or Community *

Did you attend a Legacy Lecture Series *

If so, which one?

SHORT QUESTIONS:

(125 words max for each question)

What does Leadership mean to you? Define Leader in your own words? *

What would your participation in AYEL mean to you? What qualities would you bring? *

What are your career goals? *

Print Name *

Date *

Fields marked with '*' are mandatory