Children’s Action Alliance Lived Experience Leadership Academy (LELA)

Depending on project choice and work collaboration, the time commitment for this program could range from 3-10 hours per month.

If you are selected for this program, we ask that you prioritize your time dedicated to this program. Thank you!

**You will receive notice of your acceptance to CAA's LELA October 13th, 2023.

First two sessions:

Friday, 11/17 11-2pm Friday, 12/8 11-2pm

Question Title

* 1. Please fill out your contact information

Name

Employer or Affiliation (if applicable):

Address

Address 2

City

State

ZIP/Postal Code

Email Address

Phone Number

Question Title

* 2. Please briefly describe a health issue in Arizona, or a systemic barrier you have personally encountered, that concerns you and about which you would like to advocate.

Question Title

* 3. Have you previously been part of any training related to healthcare or advocating for health change?

Question Title

* 4. What interests you in applying for the Lived Experience Leadership Academy (LELA)?

Question Title

* 5. Are you, or have you previously been, enrolled in Medicaid/AHCCCS/KidsCare or another public form of health insurance? Or have you been a caretaker of someone who has been?

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* 6. Please list two references and their name, phone number, and e-mail. One reference can be a family member.

1st Reference

2nd Reference

Question Title

* 7. Are you able to attend in-person and virtual (check those that apply)

Virtual

In person

Both

Children’s Action Alliance Lived Experience Leadership Academy (LELA)

Question Title

* 1. Please fill out your contact information

Question Title

* 2. Please briefly describe a health issue in Arizona, or a systemic barrier you have personally encountered, that concerns you and about which you would like to advocate.

Question Title

* 3. Have you previously been part of any training related to healthcare or advocating for health change?

Question Title

* 4. What interests you in applying for the Lived Experience Leadership Academy (LELA)?

Question Title

* 5. Are you, or have you previously been, enrolled in Medicaid/AHCCCS/KidsCare or another public form of health insurance? Or have you been a caretaker of someone who has been?

Question Title

* 6. Please list two references and their name, phone number, and e-mail. One reference can be a family member.

Question Title

* 7. Are you able to attend in-person and virtual (check those that apply)

Question Title

* 8. Do you have any dietary restrictions? Please be specific if so!