Youth Applicant Portion

This segment is for the youth who is applying, below there will be some questions the parent/guardian must complete to submit the application.

Youth for Health and Justice
The Summer Leadership Institute is a program for high school girls entering grades 9th – 12th during the 2023 - 2024 school year. This summer we are excited to offer Youth for Health and Justice, from June 20th - July 14th (no program Monday, July 4th).

Youth for Health & Justice
Youth for Health & Justice is for girl identified youth who are looking to be a part of the movement for equity and respect for all. In this summer program, teens will learn about the movement to ensure a future where everyone has access to quality healthcare- focusing on reproductive health inequities in our communities and country. Teens will get the knowledge and tools to become powerful advocates for themselves and their loved ones, learning their reproductive health rights as young people and exploring the gaps that exist in our country that result in women, girls, BIPOC folks, and LGBTQIA+ folks lacking complete access to health services they deserve. Teens will share and learn in a safe and open space where they can create connections with each other and their facilitator, all while gaining self-advocacy skills that will support them for a lifetime. At the end of the summer program, they will work together on a fun art or media project focused on raising awareness for others about the importance of reproductive health.

Youth will get a $200 stipend for participation and project completion.

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* 1. Youth/Applicant's Full Name

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* 2. Youth/Applicant's Date of Birth

Date

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* 3. Youth's Primary Home Address

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* 4. Youth's Cell Phone (if applicable)

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* 5. Youth's Email Address

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* 6. Please select your preferred method of contact

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* 7. What high school do you currently attend or will attend in the Fall?

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* 8. What grade are you currently in?

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* 9. How did you learn about the Summer Leadership Institute - Youth for Health and Justice? Please list name(s) if applicable.

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* 10. Are you involved or have you been involved with any Girls Inc. programs?
(Select all that apply)

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* 11. Do you have family members who have been part of the Girls Inc. Program?
(Please list there name and the program they were in)

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* 12. Will you be involved in any additional activities this summer, such as summer school, working, sport teams? If applicable, please list activities:

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* 13. Why do you want to be part of the Youth for Health and Justice?
(Please answer in two to three sentences)

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