Application – Afro-American Cultural & Historical Society, Tri-City Area

Prerequisites

The following requirements MUST be met. Proofread your written responses to ensure correctness and completeness. A completed application includes all of the items listed below.

Type no more than a paragraph: “What are your goals for the future?”(Required)

Type at least 250 words on one (1) of the following topics (Note the question number you are answering): 1. This year’s Black History Month national theme is: “African Americans and Labor." Why is it important to you that we educate others about our extensive contributions to the development—and wealth—of America? 2. What’s your view of the many challenges and obstacles facing African Americans—and what needs to change—in order for there to be greater opportunity, meaningful justice, and realistic equality here? 3. What have you learned from Black history and culture that has inspired you to pursue furthering your formal education?(Required)

Attach two (2) letters of reference(Required)

Drop files here or

Max. file size: 100 MB, Max. files: 2.

One (1) from your high school counselor, teacher or administrator, and one (1) from another adult who knows you well (not a parent or relative)

Upload a wallet-size senior graduation (or other) color photo of yourself(Required)

Accepted file types: jpg, png, Max. file size: 100 MB.

If you have an acceptance letter from a (community) college, trade school or university, please submit a copy

Accepted file types: pdf, Max. file size: 100 MB.

Personal Information

Tell us more about yourself in this section.

Name(Required)

First Last

Email(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

School now attending(Required)

Counselor(Required)

Parent(s)/Guardian(s)(Required)

Parent/Guardian Cell Phone(Required)

Parent(s)/Guardian(s) Employer & Type of Work(Required)

Sibling(s)(Required)

Sibling Name

Sibling Age

Sibling Name of School/College

Name of Trade School/College/University you plan to attend(Required)

Intended Major or focus (if known)

List any awards and/or honors you have received

List extra-curricular school activities/volunteer work you have participated in

List jobs you have held and names of employers

Job Title

Employer