Application for Reconceptualizing Blackness - A Youth Call to Action
We invite youth of all races and spiritual traditions to apply to attend The Wilmette Institute’s first anti-racism week for youth focusing on the black experience. Green Acre is providing the venue for the week.

Please PLEASE READ THE COURSE DESCRIPTION before continuing with this application:
https://www.greenacre.org/event/reconceptualizing-blackness-a-call-to-action/ 

This camp is intended for students in high school, ages 14-18.

Camp will begin on Monday evening, July 25th, and run through Saturday afternoon, July 30th.

Tuition is $540
If you think you might need a scholarship to attend, please contact us at green.acre.anti.racism@gmail.com

Applications are reviewed in the order received.

You can contact us at green.acre.anti.racism@gmail.com


Required questions are marked with a red star*
Sign in to Google to save your progress. Learn more
Email *
First Name *
Last Name *
What name do you prefer to be called?
Are you vaccinated for COVID? *
What's the best way to get a hold of you (if not email)?
Email address of your parent or legal guardian (Used to obtain a permission slip, and inform them about camp) *
Where do you live?  (City and State/Province) *
Age (as of July 25th, 2022) *
Grade Next Year (What year of school will you be entering in Autumn 2022?) *
Do you have a religion or spiritual practice? Tell us more... (1 sentence) *
Free Response Questions
Please answer questions in this section to indicate your interest in racial justice, your interest in attending camp, and to give us a sense of who you are. Please keep your answers short. Suggested length is listed by each question.

Four of the questions are optional. Choose 1-3 of the optional questions to answer, and leave the rest blank.
Tell us a bit about your racial or ethnic background, how it affects your life, your personality, and/or your worldview. (required, 1-2 short paragraphs) *
What experiences & learnings do you want to get out of this week.? What are you willing to do or contribute to make this happen? (required, 1-4 sentences) *
If you could make one thing different with regards to race or race relations in America, what would it be? (optional, 1-3 sentences)
List any books or articles you have read on the topic of racial justice. Or, are there any you would like to read? (optional)
What racial justice activities are you involved in? (In your high school, religions community, or local community) (optional, 1-4 sentences)
What do you think you can do, or what do you plan to do to help resolve racial justice issues in your community? (optional, 1-4 sentences)
Other Info About You
Let us know a bit more about you.
List any other talents and interests you have, and star those you might like to share during camp.
What races do you identify as? *
Required
One of our goals with this camp is to capture the lectures, Q&A sessions, and some discussion sections on video for use in the online version of this course in the future. Final edited videos will be posted publicly online. So, video cameras will be present, and a photo release will be requested from you as well as your parents/guardians. Please summarize this back to us in your own words. (So we know you read it!) *
Are you coming with friends? (Let us know the names of your friends, family, youth group members, etc who you are applying with and who you can continue your racial justice work with when you get home. We will group you together when we break into small groups.)  Email us at green.acre.anti.racism@gmail.com if your answer to this question changes after you submit this form.   *
Do you think you will require a scholarship to help cover the cost of your attendance?
Clear selection
How can we help you in your future racial justice work?  (optional, 1-3 sentences)
Is there anything else you would like us to know about you or your application, or questions you would like us to answer?
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms