2016 Seeding Change Fellowship
Fellowship Application Form
This document is for your reference only. Please complete the application online at: http://www.seedingchange.org/programs/fellowship/2016application/. If you have any problems submitting your application
and resume, please contact Linda Lee at linda@seeding-change.org.
I. Personal Information
1. Contact Information
First Name:
Last Name:
Phone:
Email Address:
2. Current Mailing Address
Address:
City:
State:
Zip Code:
3. Permanent Address (if Different)
Address:
City:
State:
Zip Code:
4. Demographic Information
Race/Ethnicity
Self-Identified
Gender:
Gender Pronoun
Age
Sexual Orientation
5. Availability
First Day Available for Fellowship:
Last Day Available for Fellowship:
Updated: 3/24/16
6. Do you have a valid driver's license and/or access to a vehicle? (Note this is NOT a
requirement)
Yes
No
7. Please rate your ability in each language (i.e. understand, speak, read, write).
Some organizations who need language capacity may conduct language assessment
as a part of the interview process.
Example:
Spanish: fluent in reading, writing, and speaking
Cantonese: conversational speaking only
Language
Oral Fluency
Literacy (Reading & Writing)
8. Academic Information (if applicable)
School Name:
Major/Degree:
Expected/Actual Graduation Date:
II. Short Response Questions
1. What is your vision of an ideal society and how does it compare to what we have
today?
2. What type of work do you want to pursue in the future and why?
3. Describe in detail your current and past involvement with community,
religious/spiritual, political, social justice, and other groups.
4. Describe a time/experience in your life when you have displayed leadership.
5. What in your life experience has influenced your views of social change and your
desire to become an activist or organizer?
6. How do you relate to the struggles facing working-class AAPI communities?
7. What do you hope to gain by participating in this Fellowship? Describe which
skill areas you hope to most develop.
8. How did you hear about the fellowship?
Do you have access to scholarships/work-study/stipend through any program that you are
a part of? If so, please describe. If not, please let us know what kind of needs you have
for income/employment over the summer.
Updated: 3/24/16
Site Preferences:
Please rank your host site preferences. The final host sites and fellows will be chosen
based on a matching process.
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Asian Americans United (Philadelphia, PA)
Asian Pacific American Network of Oregon (Portland, OR)
Asian Pacific Environmental Network (Oakland,CA/Richmond,CA)
CAAAV Organizing Asian Communities (New York, NY)
Chinese Progressive Association Boston (Boston, MA)
Chinese Progressive Association San Francisco (San Francisco, CA)
DRUM South Asian Organizing Center (New York, NY)
Filipino Advocates for Justice (Oakland & Union City, CA)
Filipino Community Center (San Francisco)
Khmer Girls in Action (Long Beach, CA)
RAISE (New York, NY)
Southeast Asian Coalition (Charlotte, NC)
Ugnayan Youth for Justice and Social Change (New York, NY)
VAYLA (New Orleans)
Site #1:
Please share why you would like to be at this site.
Site #2:
Please share why you would like to be at this site.
Site #3:
Please share why you would like to be at this site.
III. Interest in Fall Civic Engagement Extension
Seeding Change is deeply invested in growing the impact of Asian Americans through
civic engagement and electoral politics. This year, we are piloting a “Civic Engagement
Extension” which will take place during the Fall 2016. The Civic Engagement Extension
will be open to 2016 Seeding Change Fellowship participants and alumni of the Seeding
Change program. The plans for the CE Extension are still very preliminary.
Please mark below your interest and availability to participate in the CE Extension. We
expect that the CE Extension will be full-time. We will be following up with all
individuals who are interested and able to participate in the CE Extension at a later time.
Yes, I am interested in participating in the Civic Engagement Extension.
Yes, I will be available to participate full-time in the Civic Engagement Extension
during the Fall of 2016.
IV. References
Updated: 3/24/16
1. Please list 2 references and their contact information below, including their emails and
phone numbers.
Please prepare a resume to upload on the application.
Updated: 3/24/16