Baton Rouge Youth Coalition

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Disclaimer: There is no way to save your work on this page before submitting the form. To prevent losing your work, consider downloading a copy of the application to use as a worksheet, then transfer your answers into the online application form when you are ready. Proofread your work and pay attention to capitalization, punctuation, and accuracy. Keep in mind that we assume this application is a reflection of your very best work and thinking.

BRYC Application Form

About You

First Name (required)

Middle Initial

Last Name (required)

Birthdate (required)

Gender (required)

Address (required)

City (required)

State (required)

Zip (required)

Cell Phone (required)

What is the best phone number for us to reach you? (Even if it isn't a cell phone, put it here.)

Home Phone

Email Address (required)

Academics

Current School (required)

Expected Graduation (required)

Estimate if you don't know the exact date.

School Type

Entry Date (required)

When did you start attending your current high school?

List all summer programs in which you have participated since 9th grade, and briefly describe your role in them.

List any honors or AP classes you have taken since 9th grade.

Separate classes by commas and format them like this: AP U.S. History

Grade Point Average (GPA) (required)

Round to two decimal places. Ex. 3.58

Attach a copy of your transcript if available. An unofficial copy printed from the internet is acceptable.

List any standardized test (ACT, SAT, PLAN, PSAT) you have taken, and your score in the space below.

Example: ACT: 24, PLAN: 18, etc.

List all sections of the EOC you have taken and your achievement level for each. Use the formatting below.

Example: English II: Good; Algebra I: Excellent; Geometry: Fair; etc.

Since ninth grade, have you ever been suspended or expelled from school? (required)

Yes

Have you ever been convicted of a misdemeanor, felony, or other crime? (required)

Yes

If you answered yes to either or both questions, please write a separate essay that outlines the approximate date of each incident and explains the circumstances of the incident.

Activities

Please list up to four extracurricular activities in which you have participated since 9th grade - e.g. sports, clubs, youth government, etc. These do not only have to be activities offered by your school.

Activity #1

Grade Level

Season

Name of Organization

Example: school, church, team, community-based organization

Activity #2

Grade Level

Season

Name of Organization

Example: school, church, team, community-based organization

Activity #3

Grade Level

Season

Name of Organization

Example: school, church, team, community-based organization

Activity #4

Grade Level

Season

Name of Organization

Example: school, church, team, community-based organization

Work Experience

Please list paid jobs you have held during the past three years (including summer employment).

Place of Employment #1

Position

Start Date

End Date

Supervisor

Phone

Place of Employment #2

Position

Start Date

End Date

Supervisor

Phone

Place of Employment #3

Position

Start Date

End Date

Supervisor

Phone

References

Provide the name and information for people who can serve as references for you. This can be employers, teachers, or anyone else that knows you well, but NOT family members of friends. A letter of recommendation from one of your references is preferable but not required.

Name #1

Phone

Email address

Relationship

Name #2

Phone

Email address

Relationship

Name #3

Phone

Email address

Relationship

Writing

Short Answer: Please answer the following questions in about 250 words.

What do you think is the biggest problem in Baton Rouge? If you had unlimited resources, what would you do to fix it? Explain.

Write your answers here. (required)

For a few reasons, you may want to draft this in a word processor. First, please run a spelling and grammar check. Second, save your work, then copy/paste the text into this box. If you accidentally navigate away from this page, you will lose all of your work.

Essay: In about 500 words write a thoughtful and detailed essay based on one of the following prompts.

A) Some students have a background or story that is so central to their identity that they believe their application would be incomplete without it. If this sounds like you, then please share your story.

B) Recount an incident or time when you experienced failure. How did it affect you, and what lessons did you learn?

C) Reflect on a time when you challenged a belief or idea. What prompted you to act? Would you make the same decision again?

D) Describe a place or environment where you are perfectly content. What do you do or experience there, and why is it meaningful to you?

E) Discuss an accomplishment or event, formal or informal, that marked your transition from childhood to adulthood within your culture, community, or family.

Choose a topic of your choice.

Prompt (required)

Which essay prompt did you answer?

Write your essay here. (required)

Signature

By typing your name below you agree that all of the information provided on this application is truthful and that all written materials are your own work.

Type your name.

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