Exit this Survey

The Sullivan Selma Internship is in its beta year. We are looking for a group of student participants who are excited to provide feedback to the program and help grow it for future years. As such, we are looking for participants in this first year who are excited and willing to work with a program in its formative first year.

Question Title

* 1. Name

Question Title

* 2. Email

Question Title

* 3. Telephone Number

Question Title

* 4. Permanent Mailing Address

Question Title

* 5. Student Mailing Address

Question Title

* 6. What school are you from?

Question Title

* 7. Major +/or Minors

Question Title

* 8. Year in School

Question Title

* 9. Date of Birth

Question Title

* 10. What is your preferred gender identity?

Question Title

* 11. Have you attended previous Sullivan programming before?

Question Title

* 12. Why are you interested - and uniquely qualified - in participating in the Sullivan Selma Internship? 

Question Title

* 13. How do you anticipate this program will support your personal growth and desire to help communities?

Question Title

* 14. Which of the two programs (1 - 'New Possibilities' Youth Program; 2 - Nutrition + Food Program) are you interested in supporting during the internship, and why?

T