Skip to content

2024 - 2025 EmpowHer Leaders Academy Application

To be eligible to participate in EmpowHer Leaders Academy an applicant must meet all of the following requirements:

1. Be currently enrolled in high school
2. Able to attend all weekly Saturday meetings
3. Submit application 

Application Information
1.First Name(Required.)
2.Last Name
3.Date of Birth (MM/DD/YYYY)
4.What is your primary ethnic culture/group?(Required.)
5.Name of your High School or High School you will be attending(Required.)
6.Current Grade:(Required.)
7.Current Weighted G.P.A. :
8.Do you qualify for free or reduced school lunch?(Required.)
9.Home Address:(Required.)
10.Your Phone Number (please do not include symbols, spaces, or dashes)(Required.)
11.Your email(Required.)
12.Adult T-Shirt Size
Parent Information
13.Parent's First and Last Name:(Required.)
14.Parent's Phone Number (Please do not include any symbols, spaces, or dashes)(Required.)
15.Parent's Email(Required.)
EmpowHer Leaders Academy Meetings
16.Will you be able to attend in-person meetings in Los Angeles (Crenshaw District area)?(Required.)
17.Do you have reliable transportation to get to the meetings?(Required.)
18.Will you need assistance with transportation to get to meetings?(Required.)
19.Do you have access to reliable computer technology and the internet?(Required.)
Referral Information 
20.How did you learn about EmpowHer Leaders Academy?(Required.)
Interest Response Questions
21.After learning about EmpowHer Leaders Academy, why do you want to become a member?(Required.)
22.What will EmpowHer Leaders Academy gain by having you as a member?(Required.)
23.Why is it important to form a sisterhood with your fellow EmpowHer Leaders Academy members?(Required.)
24.How do you feel that EmpowHer Leaders Academy can help you?(Required.)
General Questions
25.What challenges are you facing (school & home)? (Required.)
26.What topics would you like to discuss during our sessions?(Required.)
27.What college do you want to attend?(Required.)
28.What career do you want to pursue?(Required.)
29.What do you like to do outside of school? What are your hobbies?(Required.)