Affirmations' Youth Leadership & Job Readiness Program Application

About This Program

Affirmations' Youth Leadership & Job Readiness program is a 16-week program focused on developing Trans, Queer, and Two-Spirit (TQ2S+) and ally youth in their leadership journeys and providing job readiness skill training. Participants will be a part of a cohort of other youth interested in engaging topics surrounding leadership, teamwork, communication, TQ2S+ identities and history, resume building and more!

Local TQ2S+ professionals and other area professionals will present various topics to youth participants. These help develop both professional workforce skills and healthy social skills. Resume building, mock interviews, financial aid, budgeting, healthy relationships, and coping skills are a few of the presented topics.

Youth receive monthly stipends for their participation in the form of gift cards, the process to receive these will be covered in the program. Participation and attendance during all meetings is required for a youth to receive their full stipend.

Application Deadline: Wednesday, January 31st at 11:59pm

Program Dates: Wednesdays at 4:30pm-6:30pm (February 7, 2024 - May 22, 2024)

Who Can Apply: TQ2S+ and ally youth ages 14-18

Returning members should not submit this form. If you are a returning member, please reach out to jvolpe@goaffirmations.org to receive the Youth Leader application.
If you are a returning member not wanting to apply to be a Youth Leader and believe you would benefit from attending this program again, please email jvolpe@goaffirmations.org before applying.

Where: Virtual via Zoom

Applicant Information

Legal Name

First Name

Last Name

Name You Use (if different from Legal)

First Name

Last Name

Pronouns:

Ex: they/them, she/her, he/him

Date of Birth

(mm/dd/yyyy)

Age:

Must be 14 by February 7, 2024. Must not be over the age of 18 before May 22, 2024.

Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Youth Email

Verify Email

Primary Phone:

Please only give a number that you feel comfortable with us calling. If you do not have a phone number that we can call please have an email address.

School:

Grade:

Year Completed School, Diploma, or GED:

Parent/Guardian + Emergency Contact Information

Parent/Guardian Name (if under 18)

First Name

Last Name

Parent/Guardian Phone Number

Type n/a if you are 18 or older.

Parent/Guardian Email

Type n/a if you are over 18 years old.

Verify Email

Emergency Contact Name

First Name

Last Name

Emergency Contact Number

Emergency Contact Relation

Ex: mom, grandparent, sister, etc.

Is this person affirming of your sexuality / gender identities?

What name does this person know you by?

Optional Demographics

The requested demographic information assists us in understanding the diversity of applicants and helps us to ensure new classes are represented by groups being systemically marginalized. Be advised you are not required to answer these questions and choosing not to will not count against you. All demographic information will be kept confidential and will only be used for program purposes. If you do not wish to answer you can leave the question blank.

Gender Identity - "Other"

If you selected "Other" to the previous question, please feel free to share more here.

Sexuality/Attractionality - "Other"

If you selected "Other" to the previous question, please feel free to share more here.

Race - "Other"

If you selected "Other" to the previous question, please feel free to share more here.

Religion - "Other"

If you selected "Other" to the previous question, please feel free to share more here.

Geographical Information

Detroit

Livingston County

Macomb County

Oakland County

Wayne County (outside of Detroit)

Other

Geographical Information - "Other"

If you selected "Other" to the previous question, please feel free to share more here.

Do you have any physical or mental health concerns or diagnoses that you would like us to be aware of or require support for?

Are there any other identities you hold that were not captured in these questions that you would like to share?

Written Responses

The following questions allow us to learn more about you and why you are interested in this program. These responses will be taken into consideration when we select the upcoming cohort's members. Please ensure that all responses are at least 3 sentences long and no longer than 2 paragraphs.

What leadership qualities or skills would you like to improve upon?

What other activities are you involved in? Why are those important to you?

Feel free to share about any school or non-school activities such as sports, clubs, classes, internships, jobs. etc.

What do you hope to accomplish as a result of participating in this program?

This program is provided over Zoom and requires active participation. Do you have a working device with access to a microphone and camera?

I do

I do not

Additional Information

How did you hear about this program?