My Hood, My City LB 2023 application form
Welcome to Youth Leadership Institute's "My Hood, My City" summer program, in partnership with the City of Long Beach & M3 Chicago. In My Hood, My City, youth will cultivate a media project highlighting the beauty and the struggle of their neighborhoods through photography, writing, and interviewing practices. My Hood, My City will run through the summer, with weekly in-person meetings from June to August. The program will culminate with youth-led community tours in August where youth will educate Long Beach at large about their neighborhoods! Participating youth who attend all program events will earn a stipend of at least $600.

The information you share here will only be shared with our staff. My Hood, My City is open to Long Beach youth ages 14 to 24 who live in the Washington neighborhood. We are no longer accepting applications for the Northside and Westside. There is limited space in this program so act fast, as all available spaces may get filled! If you have any questions, please contact yli Long Beach Program Manager Erron Harris at eharris@yli.org and/or Senior Program Coordinator Carlos Omar at comar@yli.org. 

If you aren't eligible for this program but are interested in getting involved in other programming, check out what we have to offer here: https://yli.org/region/long-beach/

If you are a parent filling this form out for a child, please fill it out using their names and birthdates. This helps avoid us confusing the application being filled out for someone older than the eligible age range for this program. Thank you! 
Sign in to Google to save your progress. Learn more
Email *
Please add your first and last name. *
Please add your home address. *
This program is only open to youth living in the Northside, the Westside, or the Washington neighborhood. If you are outside of these areas but in Long Beach, you may be eligible for other programs we offer.
Please add your birthdate. *
This program is only open to youth between the ages of 14 to 24 years old. Unfortunately, we do not have programs available to people younger or older than this age range. If you are a parent or guardian filling this out for your child, please answer with their birthdate.
MM
/
DD
/
YYYY
If you attend school, what school will you be attending in the fall?
 *
Please know that attending school doesn't impact your ability to participate in this program. You're eligible to participate as long as you are within the age range and neighborhoods listed above. We're just asking this so we have an idea of what local schools are represented in our programs.
What are your pronouns? Please select all that apply.
 *
We want to make sure to respect how you identify and will ask other program participants to also respect this. If you're unfamiliar with the concept of pronouns, check this out: https://uwm.edu/lgbtrc/support/gender-pronouns/
Required
What is a good phone number for us to text you at?
 *
Your phone number (and email address) will not be shared with other youth or staff without your permission. We use this to communicate about meetings, answer questions, etc.  This can be yours or a parents.
What methods of transportation do you have access to?
 *
Most of the work we'll be doing will be happening in your neighborhoods, so it may be possible to walk, bike, skate, etc. to meeting locations. For events happening elsewhere, we can also provide rides. This does not impact your eligibility to participate, it just helps us plan appropriately for how many people may need rides.
Required
Do you have access to a camera or laptop? If yes to all the answers that apply. If you don't have any, check "none." *
We ask this to know if we need to provide these materials for you, which we can do. Answers to this question will help us know how many of each item to prepare so that youth can participate in all program activities.
Required
Do you have any allergies or other dietary needs we need to know about?
We ask this because we do try to provide snacks, drinks or food for some program activities. If you don't have any, just skip this question and submit the form.
Have you ever traveled out of California? What was that experience like for you? If there was an opportunity to travel with the program during the summer, would you be open to that? *
What is your preferred shirt size? *
This is good for us to know just in case we were to have program swag we could give out!
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of Youth Leadership Institute. Report Abuse
Google Forms