Native American Health Center Youth Services Program Youth Development Fellowship Application
Deadline: Wednesday May 25, 2011 by 5:00pm ____________ Date
____________________________________________________________________________ First Middle Last ___________________________________________________________________________________________ Address City State Zip ___________________________________________________________________________________________ Home phone Cell phone ___________________________________________________________________________________________ Date of Birth Tribe/Ethnicity ___________________________________________________________________________________________ Name of School Grade ___________________________________________________________________________________________ Address City State Zip ___________________________________________________________________________________________ Hobbies and Interests
Please provide two references (other then a relative):
___________________________________________________________________________________________ Name Phone Relationship ___________________________________________________________________________________________ Name Phone Relationship
Applicants-‐‑ please answer the following questions clearly and thoroughly to assist us in understanding your goals and qualifications. Remember the applications process is very competitive. Many of the following questions will be asked when applying to universities & scholarships. Type your answers and submit them with the application. Please type your answers on separate sheets of paper. The following 8 questions are for NEW APPLICANTS:
1. Youth Fellows participate in a rigorous, fast paced work environment where meeting deadlines and voicing your opinions and concerns is vital for success of the program. Give an example of a significant experience that illustrates your ability to adapt to this pace and environment. You may use previous experiences from past involvement in sports, school or in the community. (Minimum of 200 words)
2. What would you like to do after high school? Where do you see yourself in five years? How will this Youth Development Fellowship help you to reach your goals? (Minimum of 250 words) 3. Name 3 issues that affect you and your community. How do you think these issues can be changed? 1. (Minimum of 100 words) 2. (Minimum of 100 words) 3. (Minimum of 100 words) 4. Name one obstacle you have had to overcome as a young person. Describe. (Minimum of 100 words) 5. If you could pass any law affecting youth, what would it be and why? (Minimum of 100 words) 6. What is an accomplishment you are most proud of? (Minimum of 50 words) 7. Tell us about a talent, experience, contribution or personal quality you will bring to the Fellowship. (Minimum of 50 words) 8. Who is the biggest influence in your life? How have they impacted you? (Minimum of 50 words) In addition, all applicants must submit a professional resume of past work experiences and/or volunteer experience this includes internships, extra curricular activities and community involvement.
If you have participated in the Fellowship in the past please answer the following 10 questions: 1. What have you learned from your participation in the past fellowship program? How do you plan on utilizing those skills in this years Fellowship? Have you acquired new skills/knowledge/experiences that will add to the program, if so what are they? (Minimum of 200 words) 2. Since your participation in the fellowship how have you stayed active within the community? If you have not, why? (Minimum of 150 words) 3. In the past year what is one book or film that has left an impact on you? Why? Would you recommend other youth see it or read it? (Minimum of 50 words) 4. What topics or issues would you like to see covered over this year’s Fellowship? (Minimum of 50 words) 5. Give an example of a time you have voiced your opinion to stand up for yourself or someone else. What was the outcome? (Minimum of 100 words) 6. What are your current short term goals (within the next two years)? How can the Fellowship help you meet those goals? 7. Describe the world you come from—for example, your family, community or school—and tell us how your world has shaped your dreams and aspirations. (Minimum 250 words) 8. Write about an experience/achievement and its effect on you. (Minimum of 75 words) 9. What educational activity or fieldtrip would you suggest for the youth from the Summer Program? 10. Why should you be reconsidered for the Fellowship? (Minimum of 50 words) In addition, all applicants must submit a professional resume of past work experiences and/or volunteer experience this includes internships, extra curricular activities and community involvement.
Your application can be mailed, hand delivered to Youth Services Drop in Center, or can be emailed to TahneeC@nativehealth.org. For more information and any questions, please contact Tahnee Camacho at the number provided below.
Native American Health Center Youth Services Program 3124 International Blvd. (entrance on 1st Floor on the corner of 31st Ave) Oakland, CA 94601 Phone: (510) 434-‐‑5330 Fax: (510) 437-‐‑9574
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Answer all essay questions completely, remember the word counts. Complete application with 2 references (non-‐‑relatives) Professional Resume Remember to proof-‐‑read application, essays, and resume Deadline Wednesday May 25, 2011 by 5:00 pm
Remember, incomplete or late applications will not be accepted!