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Student Application

Location *
Select the location you'll be applying to.Adrian College in Adrian, MichigainBoston University School of Theology in Boston, MassachusettsNebraska Wesleyan in Lincoln, NebraskaGarrett Evangelical Theological Seminary in Chicago, Illinois
Program For: High School Students (July 21-24)
Program For: High School Students (July 25-29)
Program For: TBA
Program For: College Students Only (June 27 - July 1)

Student Information

First Name: *

Last Name: *

Middle Initial

Preferred Name:

Home Address: *

Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry

Primary Phone Number: *Please enter the best phone number to reach you.

Email: *

Gender: *

MaleFemale

Birthdate: *mm/dd/yyyy

I am at least 18 years of age: *

YesNo

Parent(s)/Legal Guardian(s): *Enter the names of your parents or your legal guardians in the space provided.

Parents' Primary Phone Number: *Please enter the best phone number where we can reach your parents.

Parents' Secondary Phone Number: Enter an additional phone number where your parents can be reached (optional).

School Name: *Enter the name of the school you currently attend.

City: *Where is your current school located?

Grade (High School Students): *What grade will you be in this fall?

Grade (College Students): *What grade will you be in this fall?

Extracurricular Activities and Hobbies:

Church Information

Jurisdiction: *Please select your jurisdiction from the list.

Annual Conference (Western Applicants): *Please select your annual conference from the list below.

Church: *Enter the name of your church in the space provided.

City: *Enter the city where your church is located in the space provided.

Church Pastor: *Enter the name of your pastor.

Pastor's Phone Number: *

Describe your involvement with the church: *

In a few sentences or a short list, describe how you're involved with your church.

Recommendation

A letter of recommendation is required as a part of the application process. Select a person (adult) who knows you well from your local congregation and is not a family member. Remember to include the recommendation with your application.

Recommender: *Enter the name of your recommender.

Relationship to you: *What is your recommender's relationship to you?

Recommender's Primary Phone Number: *Enter a phone number where your recommender can be reached.

Recommender's Secondary Phone Number: Enter an alternate phone number for your recommender (optional).

Recommender's Email: *

Sponsor

A sponsor is required to help you with prayer during your time as part of the academy and provide you with the $50.00 application fee to be sent with this application.

Sponsor: *Please enter the name of your sponsor in the space provided.

Relationship to you: *

Sponsor's Primary Phone: *Enter the best phone number where we can reach your sponsor.

Sponsor's Secondary Phone Number: Enter an alternate phone number for your sponsor.

Email: *Enter an email address where your sponsor can be reached.

Personal Narrative

At the Hispanic Youth Leadership Academy, we are interested in getting to know you. We want to hear from you about what intrigues you and has shaped your development as a young person. Therefore, we would like you to give us your personal narrative as essay statements responding to each of the following questions. There is no right or wrong response. Remember to attach your narrative to this application form. Make sure to include your name and address on your personal narrative.

Write essay statements for each question. Responses to each question should be on at least 200 words double-spaced. Please type your responses and be sure to include your name on every page.

Tell us about yourself. Tell us what you consider to be most important about you that others might not recognize.
What challenges or obstacles do you think Hispanic youth or Young Adults face today?
Describe your experience/participation in church and share why you think it is important to explore your call to serve God?
What interests you most about the Hispanic Youth Leadership Academy? What questions, concerns or issues are you interested in exploring through your participation in the Academy?

Upload personal narrative essay: *(must be in .doc or .docx format)

Please Read Carefully and Sign

I certify that all of the above information is correct to the best of my knowledge and the enclosed submissions are solely my work. I understand that in order to participate in the Hispanic Youth Leadership Academy, I must find a sponsor. If accepted as an emerging leader and if I choose to attend, I agree to participate for the full duration of the program and to abide by the rules and regulations of the Hispanic Youth Leadership Academy (HYLA).

Electronic Signature: *Enter your full name as an electronic signature.

Verification

* After submitting the application you will be automatically redirected to PayPal where you can pay the non-refundable $50 application fee. This payment will show up as ALCAMEN on your bank or credit card statements.
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