Empact Fellowship Application

We are excited to learn of your interest in becoming an Empact Fellow. Please review the program FAQs and complete the application below. We encourage you to contact info@byeinstitute.org with any questions or if you require assistance with this application. You will be able to save and resume your application later if needed.

Name

First

Last

Preferred Name

Date of Birth

Gender

Pronouns

Do you consider yourself Hispanic or Latino?

Yes
No

Regardless of your answer to the above, please select one or more of the following racial categories to describe yourself and/or your family:

Email

Mobile Number

What Cincinnati neighborhood do you live in?

What neighborhood do you live in?

Address

Address Line 1

City

State

Zip Code

How did you learn about us?

Please tell us how you learned about us.

Tell Us More About You

Current High School

The Empact Fellowship has been created to support students who attend Cincinnati Public High Schools. If space permits we may consider students from outside the CPS district.

What school do you attend?

Please indicate your current class standing

Are you prepared and able to continue your fellowship for one year following graduation

Yes
No

The Empact Fellowship requires a 15 to 20-month commitment. If you would like to be considered for a 12-month internship please upload your resume below.

Current GPA

All students are encouraged to apply regardless of GPA

Do you currently receive free or reduced lunch?

Yes
No

Extracurricular Activities: Please let us know about extracurricular activities you are currently involved in (select all that applies).

Please tell us what other activities you are engaged in.

Additional Responsibilities: Please let us know about additional responsibilities you may have (select all that applies).

Please tell us what other responsibilities you have.

BYE Support: Please let us know the type of support you may need or be interested in receiving (select all that applies)

Please tell us what other areas of support you may be interested in.

Empact Fellowship Track

Empact Fellows are given the opportunity to address problems and assess needs within their schools and learn more about their communities and organizations working to improve the livelihood of Black and Brown people through two tracks:

Community Building Track – Students will focus on their schools and communities.

Restorative Justice Track – Students will focus on their schools and the justice system. Students who have experienced disciplinary action within schools or the justice system are encouraged to apply.

Empact Fellowship Track:

Community Building

Please answer the short essay questions below: (please contact info@byeinstitute.org with any questions)

Please share an area that you feel needs improvement within your school community and/or a project that you would like to work on to empower students/staff and how you might address it (consider the fact that you would have funds to address this issue and/or provide resources to members of your community).
1. State the problem or describe the project.
2. Explain how you would approach it and the steps you would take to carry out the work.

What would you say is the biggest problem that teens from the community in which you live are faced with today?
1. State the problem and how it has impacted you and your peers.
2. Share what you think should be done to solve it.

Restorative Justice

Please answer the short essay questions below: (please contact info@byeinstitute.org with any questions)

Please share the issues that led to disciplinary action being taken against you and/or areas for growth in relation to resources that may have prevented this outcome. Consider whether there are areas you feel need improvement within your school and/or community in which you live. You may also share a project that you would like to work on to empower students/staff and how you might address it (consider the fact that you would have funds to address this issue and/or provide resources to members of your community).
1. State the problem or describe the project.
2. Explain how you would approach it and the steps you would take to carry out the work.

What would you say is the biggest problem that teens from the community in which you live are faced with today?
1. State the problem and how it has impacted you and your peers.
2. Share what you think should be done to solve it.

Upload Letter of Support (Optional)

Click or drag a file to this area to upload.

You may request a letter of support from a teacher or administrator of your school, mentor, coach, or supervisor. Your reference may also send their letter to us via email at info@byeinstitute.org.

This is not a requirement, but a welcomed addition to your application.

Upload Resume (Optional)

Click or drag a file to this area to upload.

You may upload a copy of your resume.

This is not a requirement, but a welcomed addition to your application.

Upload Resume

Click or drag a file to this area to upload.

Please upload a copy of your resume.

Please confirm your understanding of the following statements by checking the boxes below:

I understand that the Empact Fellowship is a 15 to 20-month commitment that will take place over two academic school years and one summer, and there will be required assignments, workshops, trips, and field placements that will take place during this time. As an emerging young professional I understand that it will be my responsibility to be in touch with the program director if I foresee any scheduling or commitment conflicts.

.

I understand that if accepted into the fellowship my parent or legal guardian must give their expressed permission, and I must return a letter of commitment signed by both me and my parent/guardian to participate.

Signature

Clear Signature

Date

Save and Resume Later