Mindful Leaders Institute Application- Please read!
This is an application for the JAIA Mindful Leaders Institute Application.   We are looking for candidates who have a genuine interest and commitment to mental wellness and personal development. It is our intention to give first choice to youth from traditionally underserved communities (i.e. black and brown communities, first nation, latinx, lgbtq+, gender non-conforming, foster care, etc). Please fill out this form and you will be contacted for an interview. You will need an adult or former youth council member to recommend you. Please prepare to have their contact info for this application.
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Email *
Name *
First and last name
Date of Birth *
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What pronoun do you prefer us to use to refer to you by? (i.e. she/her, they/them, etc) *
Phone number *
Full mailing address (including street address, borough and zip code) *
What school do you attend? What grade will you be in this September?
 *
MLI would like to serve youth who are from traditionally underserved communities. Which of the following do you identify yourself as? Choose as many identifiers that are true for you. (this information will remain confidential but is used to diversify our team.) *
Required
How did you hear about JAIA Mindful Leaders Institute (MLI)? *
Why are you applying for the Institute?  *
Please describe your interest in personal development, mental wellness and leadership.  *
What personal goals do you think we can help you with? (i.e. personal mental wellness, taking initiative, emotional wellness, personal growth, self esteem, improve relationships, etc) *
Do you have any previous experience in an after-school youth group or leadership team/council? *
During the school year are you involved in other programs after school or on weekends? Choose all that apply. *
Required
Share the details of any of the activities, responsibilities or programs you choose above. What is the activity and how often do you participate (weekly, monthly)? What days and times do you participate?   *
The JAIA MLI meets weekly, from Sept-June 2023 Tuesdays 5:00-7:00 (virtual), and twice a month on Saturdays 1:00-4:30 in person in Manhattan. 

Are you prepared to make this time commitment to the MLI program?
 *
What skills or talents do you think you can add to JAIA Mindful Leaders Institute as an intern? *
Please list the first and last name, telephone number and email address of your EMERGENCY contact person. *
Do you have a trusted adult in your life that is willing to support you during your internship? This can be a parent/guardian/teacher/counselor, etc. A SUPPORT person is someone you trust to help when life gets challenging. *
If your response to the question above was, YES, please tell us the full name,  contact info (email and phone number), and your relationship to the adult who will support you through this internship. *
The JAIA MLI meets weekly, from Sept-June 2022 Tuesdays 5:00-7:00 (virtual), and twice a month on Saturdays 1:00-4:30 in person. Are you prepared to make a commitment for this leadership experience? (dates are subject to change, but will be confirmed at your interview) *
If you are not accepted to the Institute, would you like to join our mailing list to hear about other opportunities for youth and young adults?   *
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