iDREAM Summer Learning Institute Application

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iDREAM
for Racial
Health
Equity
2014
iDREAM Core Values: Integrate~ Diversify~ Retain~ Educate~ Activate~
Mentor. Millennial Leaders are engaged in deep discussion around 1)
eliminating racial disparities; 2) improving health equity for Black mothers and
babies throughout the life course; and 3) planning critical interventions within
Los Angeles County service planning areas (SPAs) or communities. The
iDREAM Summer Learning Institute serves as a boot-camp orientation for
interns, mentoring and program assistants.
Summer
Learning
Institute
2014 Summer Learning Institute
Cohort #4 Program Dates: July 7-11, 2014
A Summer Enrichment Program (SEP) Collaboration with
USC Diversity in Healthcare Leadership Initiative
A. PROGRAM ELIGIBILITY/REQUIREMENTS (MUST MEET CRITERIA BELOW)
 Current student or graduate of accredited U.S. college or university. Please describe if you are in high school.
 Maintain a strong academic record
 Two letters of Recommendation
 500-word Personal statement
B. PERSONAL INFORMATION
Name: ____________________________________________________________________________
Last Name
First Name
Middle Initial
Email Address: _____________________________________________________________________
Mobile Phone: _____________________________ Home Phone: ___________________________
Transportation: □ Car
□ Public Transportation
Program site located at the USC Sol Price School of Public Policy – University Park Campus
C. DEMOGRAPHIC INFORMATION
Demographic: □
Millennial
B. 1981-2000
Gender:
□
Female □
Male
Marital Status: □
Single □
Married
□
Generation X
B. 1965-1980
□
Divorced/Separated
Ethnicity: (please check all that apply)
□ Black/African descent □ Cambodian □ Caribbean
□ Cuban
□ East Indian □ Filipino
□ Korean
□ Laotian
□ Mexican
□ Native Alaskan
□ Puerto Rican □ Salvadoran
□ Thai
□ Bi-racial: _____________
D. ACADEMIC INFORMATION
I am classified as a:
□ Full-time Student
□ White
□ Chinese
□ Guatemalan □ Japanese
□ Samoan
□ Native American
□ Vietnamese □ Native Hawaiian
□ Multi-cultural: ________________
□ Part-time Student ______ hours.
Classification for Fall 2014:
High School: □ Junior
□ Senior
**additional parent/guardian release forms required for participants under 18 years of age.
College:
□ Freshman
□ Sophomore □ Junior
□ Senior
□Post-BA/BS Degree
□ Please explain if the summer enrichment program is a “gap year” opportunity. In other words, you are not currently
enrolled in an accredited college or university and want to participate in the program before completing a baccalaureate
or post-baccalaureate degree program. Describe your goals to seek or complete higher education in personal statement.
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Advanced Degree: □ Graduate School
□ Professional School
(Expected or Received) Date of Graduation ____________ (month) _______________ (year)
Academic Institution: ________________________________________________________________________________
City
State
Zip Code
Major: _______________________________ GPA* _____________________ (cumulative)
*If your academic institution is not a 4.0 scale provide the scoring conversion key from your school.
OTHER SCHOOLS ATTENDED (List chronologically all colleges and universities attended)
Name of School and Location
From
MO/YR
To
MO/YR
Degree Obtained?
Yes (please state) or No
APPLICATION CHECKLIST:
Use the following list to be sure that you have all of the necessary documents needed for consideration into the
program. Please email pdf and/or scan documents:
□ Original application. Remember only properly filled out applications will be considered for the 2014 Summer Learning
Institute. Take the extra time to make sure all blanks are filled in correctly.
□ Proof of enrollment in current the academic institution.
□ Unofficial transcripts from all academic institutions attended.
□ Personal statement of a maximum of 500 words stating:
 Describe your interest in cultural competency and health disparities to improve birth outcomes.
 What can you contribute to the Summer Learning Institute?
 Give one example of your personal leadership and what it means to you.
 Tell us your future career goals.
 Please state additional challenges, including an explanation related to your “gap years.”
□ Letters of recommendation: Submit two letters of recommendation who has direct insight into your leadership
performance within in an academic, volunteer, service learning or workplace setting.
□ Complete resume, include volunteer and community service experience as well as academic involvement and school
organizations (two pages maximum).
How did you hear about the iDREAM Summer Learning Institute?
□ Parent
□ Friend
□ Faculty/Staff
□ Other:_________________
□ iDREAM Website □ iDREAM Millennial Leaders Advisory Council □ USC Diversity in Healthcare Leadership Initiative
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ONLY COMPLETE APPLICATIONS WILL BE REVIEWED.
Cohort #4 Application Date: Saturday, May 31, 2014
Late applications will not be accepted.
Space limited to 12 applicants.
EMAIL PDF APPLICATIONS TO:
Ms. Abigail Shoaf
Program Assistant
ashoaf@idreamnow.org
Email inquiries no later than April 30, 2014 to:
Ms. Wenonah Valentine, MBA
Program Director
wvalentine@idreamnow.org
2011-2013 Alumni Ambassadors and Millennial Leaders Advisory Council
* Successfully completed the USC Diversity in Healthcare Leadership Initiative career exploration cohort
Melat Begashaw*, Cohort 2 and 10*
Meron Begashaw
Nurisha Ficklin, Cohort 3
Gabriella Galdamez, Program Intern
BA 2014, International Development Studies, UCLA
BA 2012, Anthropology, UCLA
BA 2017, Biology/Pre-Med, CSU Long Beach
BS 2013, Public Health Education/Promotion Option, CSU Northridge
MPH 2015, CSU Northridge
Lauren Hoyd, Cohort 3 BA 2015, Theater, Film & Television, USC
Aja King, Cohort 3 BA 2013, Black Studies and Film & Media Studies, UC Santa Barbara
Leora Kirk, Cohort 1 Health Administration, CSU Northridge – Cohort
Mimi Ly, Cohort 1 BA 2013, International Development Studies, UCLA
Alexis Perryman, Program Assistant, Cohort 11* BA 2013, Human Development and Textiles, UC Davis
Julio Cesar Reyes, Cohort 9* BA 2011, Sociology, Occidental College
Abigail Shoaf, Program Assistant, Cohort 3 BA 2012, Christian Ministry, Facultad of Theology
Dina Trang, Cohort 1 BS 2013, Biochemistry, UCLA
Doctor of Pharmacy Candidate 2017, USC
Elena Trang, Cohort 2 & 10* BS 2014, Biochemistry, UCLA
Velvet Watkin, Program Intern BS 2013, Health Administration, CSU Bakersfield
Piloted High School Students in 2013 career exploration and skill-building cohorts
Skill-building, Cohort 3 Diploma 2014, Health Careers Program, St. Mary’s Academy
Career Exploration, Cohort 11* Diploma 2014, Health Careers Program, St. Mary’s Academy
Skill-building, Cohort 3 Diploma 2014, Pacifica Christian
Skill-building, Cohort 3 Diploma 2016, South Region 2
Words of encouragement from “near-peers”, one alumni ambassador to another:
“We have not formally met, but I am Dina Trang another Alumni Ambassador who was a part of the 2011 Summer Learning Institute,
Cohort #1. I was in the program when I was a sophomore at UCLA, but now I am a first-year pharmacy school student at USC. Til this
day, I am still honored to have had Ms. Valentine write my letter of recommendation for pharmacy school. I am so thrilled to hear
that you are applying to the Gates Millennial Scholarship! When I was a senior in high school, I had actually looked into applying for
that scholarship as well. I remember how stressful and lengthy some scholarship applications can be, but please do not be afraid to
dream big and just go for them! You have the support of Ms. Valentine and your fellow Alumni Ambassadors. Being a part of
iDREAM’s Summer Learning Institute already speaks volumes about your drive and motivation to become an evolving leader. I have
no doubts in the great things you will do in the future.” Via email, January 10, 2014
Praise for internship experience:
“Based upon my experience, I am aware that there are organizations that focus on direct services but I appreciate that iDREAM
focuses on developing the leadership aspect of non-profit organizations. Without someone to develop leaders, there will be no one to
take the place on the forefront of these causes.” Gabriella Galdamez, via email, February 11, 2013
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