Rising Young Leaders Application

General Information

Student Name(Required)

Parent Name(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Parent Email Address(Required)

Student Email Address(Required)

Emergency Contact Name(Required)

Emergency Contact Phone Number(Required)

Education

Name of School(Required)

Grade(Required)

Age(Required)

Internships

What Internship are you applying for?(Required)

Summer Camp Intern (June-August)

Classroom Intern (Winter/Spring/Fall)

Please list any previous experience you might have working with children, in arts administration, as a camp counselor, classroom assistant, etc.:(Required)

Are you interested in working with a specific department, teaching artist or class option? If so, which ones and have you worked with this teacher/media before?(Required)

Classroom Intern hours run 3:00pm-6:00pm, Monday - Thursday. Below neatly list the days and times you are available:

Summer Camp Interns are scheduled by week from 9am-5pm. Refer to CHAW’s current summer camp catalog and neatly list all weeks/camps you are available

SPECIAL SKILLS & INTERESTS (List your skills, hobbies and activities you participate in)(Required)

HOW HAVE THE ARTS TRANSFORMED YOUR LIFE OR THE LIFE OF SOMEONE YOU KNOW?(Required)

HOW DO YOU SEE YOURSELF SHARING THE ARTS WITH YOUNGER CHILDREN?(Required)

IS THERE AN ARTIST, MUSICIAN, TEACHER OR OTHER PERSON THAT INSPIRES YOU? IF YES, WHY?(Required)

WHY IS THIS INTERNSHIP EXPERIENCE IMPORTANT TO YOU?(Required)

References

Name(Required)

Phone Number(Required)

Email Address(Required)

How long have you known this person? What is your relationship to this person?(Required)

Name(Required)

Phone Number(Required)

Email Address(Required)

How long have you known this person? What is your relationship to this person?(Required)

I certify the information contained in this application is true, correct, and complete. I understand that, if employed, false statements reported on this application may be considered sufficient cause for dismissal.

Signature of Parent/ Guardian(Required)

Signature of Applicant(Required)