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Engines of Change Student Ambassador Application 2024-2025
To apply to be an Engines of Change Student Ambassador, please complete this application by July 15, 2024 For more information, see our website:
https://hmh.org/education/programs-and-curriculum/engines-of-change/
. If you have further questions, contact
education@hmh.org
.
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* Indicates required question
Basic Information
First Name
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Your answer
Last Name
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Your answer
Preferred Pronouns
Your answer
Birthday
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MM
/
DD
/
YYYY
Phone Number
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Your answer
Home Address
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Your answer
E-mail Address
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Your answer
School you'll be attending for the 2024-2025 year
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Your answer
School Address
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Your answer
Grade entering in the 2024-2025 school year
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Freshman
Sophomore
Junior
Senior
Other:
Name of Parent or Guardian
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Your answer
Parent or Guardian Phone Number
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Your answer
Parent or Guardian Email
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Your answer
Please provide the name of someone who knows you well who we may contact (Reference)
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Your answer
Reference Email
Your answer
Sessions will be held monthly on Sunday afternoons from 4:30 -6:30 PM. Can you commit to attending 80% (8/10) meetings?
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Yes
No
Other:
Personal Information
Tell us about your personal and educational goals and any plans you may have to reach those goals.
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Your answer
What are you hoping to gain from participating in the Engines of Change program?
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Your answer
Please list other extra-curricular programs, or sports you are involved in.
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Your answer
Dinner will be included in most meetings. Please list any dietary needs.
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Vegetarian
Vegan
Kosher
Gluten-free
None
Other:
Are you a returning student?
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Yes
No
If you are a returning student, would you like to serve on the EoC Leadership Council? The Leadership Council plans the meeting topics and helps facilitate meetings.
Yes
No
I am not a returning student
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T-Shirt Size
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S
M
L
XL
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Other:
Additional Information - What would you like us to know about you?
Your answer
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