The Ed100 Academy for Student Leaders
ATTENTION, STUDENT LEADERS!
The summer conference of the Ed100 Academy for Student Leaders will be conducted online, June 20-22. Use this form to apply for membership in the Academy and admission to the conference. There is no cost.

WHAT IS THE Ed100 STUDENT ACADEMY?
This free program is designed to help you connect with civic engagement opportunities to learn and lead, in partnership with other student leaders all over California. You can learn much more about it at https://ed100.org/academy. Ed100.org is a free site that supports the development of informed school communities.

WHO SHOULD APPLY?
Students age 13 and above are invited to apply. The Ed100 Academy is for students who serve in a leadership role *or who aspire to do so in the future.*  Leadership isn't just about holding a traditional office. This program is most powerful when a school delegation includes diverse students from each grade level. (College students may also apply.)

WHEN ARE THE APPLICATION DEADLINES?
The early application deadline is April 14.
The standard application deadline is May 16.
The final application deadline is June 8.

THE Ed100 STUDENT ACADEMY CERTIFICATE
In August 2022, you'll receive a link to download your Ed100 Academy Certificate, which will reflect your participation in each day of the Ed100 Academy Summer Conference.

— IMPORTANT NOTE ABOUT YOUR EMAIL ADDRESS —
Please apply ONCE using your own, personal, long-term email address, such as a personal Gmail address. Don't use an email address provided by your school! School e-mail servers tend to block incoming emails, which makes it impossible for us to give you the information you need to attend. Last year many students were unable to participate for this reason.

Information you provide in this application form will be used in the selection process and to contact you. It will not be sold.  
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Email *
First Name *
Last Name *
Mobile Phone *
Grade level *
Your grade level in the *2021-22 school year*
Your School's Name *
Please provide the official name of your school
Location of your School *
Name of city or town
State
Not in California? OK, which state is your school located in?
Alumni *
Did you attend the Ed100 Academy summer online conference in 2021?
What race(s)/ethnicit(ies) do you identify with? (Optional)
Gender identity
Which of these best describes your gender identity?  (Optional)
Clear selection
How did you hear about this program? *
Please include the *name and title* of the person who recommended you to apply, if any. (Example: "My AVID advisor, Divesh Gonzalez")
Email address of person who recommended you
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