2022 - 2023 MPACT & WPX3 Application Form
-- REVISED 10/2022 --

Hello! This is the official application to be a part of either the Washington HS's WPX3 or Mission HS's MPACT for the 2022-2023 school year. In these programs, youth learn to identify issues in San Francisco, conduct research, and implement media education campaigns, which helps shape powerful advocates who can create lasting change in their communities in the context of alcohol prevention and other social justice topics. In order to be considered for either program, this application must be completed.

Things to consider:

1. Participants will receive stipends for their involvement, meaning this is a commitment to attend meetings and be engaged ($120 per month, so $720 for the whole school year -- NOTE: stipend is tied directly to participation and attendance).

2. This is a space to engage in topics that might be heavy concerning social justice and alcohol.

3. This is a great opportunity for leadership and contributing to the community!

4. There are only 10 slots available per program site! Apply quickly!!

The first meetings will take place in Oct, details of which classroom this is taking place will be sent to your email once application is submitted.

*SCHEDULE:
Washington: Thursdays, 4-6pm
Mission: Tuesdays, 3-5pm

READ MORE about the program here: https://yli.org/program/san-francisco-friday-night-live/

If you have any questions regarding the program, please contact Mary Toni by email at mtcerrado@yli.org.

*Schedule is subject to change due to new bell schedules and all of participants' availability.
Sign in to Google to save your progress. Learn more
Full Name *
First and last name
Email (personal ONLY, **NOT** an SFUSD email) *
Phone number *
Address *
Preferred method to reach you *
Pronouns *
Ethnicity/Race *
What program site are you applying to? *
What grade level are you in? *
What is your current age range? *
What is your gender identity? (My apologies if any term feels outdated, this is according to the state's demographic database categories) *
Tell us what interests you about joining this program to lead a social norms campaign to change youth perceptions on the risk of harm in drinking alcohol and social justice. Feel free to share the impact of alcohol in your neighborhood or school or impacts on you, your peers, or your community. *
How do you think we can change youth beliefs about the risk of drinking alcohol? *
In this space, it is a weekly 2-hour time commitment that does have a stipend. Please share any other time commitments you may have during the school year. *
Is there anything else you want us to know about your interest and passion for the program?  If not, please write, "no comment", in the space below. *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Youth Leadership Institute. Report Abuse