First Name *

Last Name *

Email *

Mobile phone * Must include area code: (123) 456-7890

Shipping address * Street address, line one

Shipping address Street address, line two

Shipping city *

Shipping state * AA AE AP AL AK AR AS AZ CA CO CT DE DC FL GA GU HI ID IL IN IA KS KY LA ME MD MA MI MN MP MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA PR RI SC SD TN TX UT VT VA VI WA WV WI WY

Shipping zip code *

LinkedIn profile Optional. Please paste a link.

Gender * New Politics Leadership Academy does not discriminate on the basis of gender identity or expression. Male Female Non-binary or third gender Other Prefer not to say

Gender: If you selected Other, we invite you to self-identify.

Race, Ethnicity, or Origin * Please select all that apply. New Politics Leadership Academy does not discriminate on the basis of race or ethnicity. AsianBlack or African-AmericanHispanic or Latina/o/xNative American or American IndianNorth African or Middle EasternPacific IslanderWhitePrefer not to sayOther

Race: If you selected Other, we invite you to self-identify.

What is the nature of your service experience? * If you identify your service under State and National AmeriCorps programs, like TFA or City Year please denote "AmeriCorps" here. AmeriCorpsAmeriCorps NCCCAmeriCorps VISTAAmeriCorps YouthbuildForeign Service OfficerHealthcare professional (including but not limited to providers, public health professionals, CDC, and policy experts)Intelligence CommunityJesuit Volunteer CorpsNonpartisan employee of a local, state or federal government officeNonprofit staffPeace CorpsState Teacher of the Year or FinalistTeacher in K-12 or nonprofit sectorSocial WorkerU.S. Air ForceU.S. ArmyU.S. Coast GuardU.S. Marine CorpsU.S. National GuardU.S. NavyU.S. Space ForceOtherNo military or national service experience

Please describe your service in 25 words or less. * *For ex: Public School Teacher from ‘94-04”, Social Worker from 2010-2021, etc.

Briefly explain why you are interested in Answering the Call and what you hope to take away from the program. * Please answer in 100-250 words.

Special accommodations Optional. New Politics Leadership Academy is committed to making our programming inclusive of all people, of all abilities. If you require accommodations in order to participate, please let us know so we can make necessary arrangements.

Participant Agreement * Applicant Statement of Understanding: The deadline for applying to the program is March 16th. Applications will be dealt with on a rolling basis, and I can expect to hear back within a week of submitting my application. I understand that because this is a small group learning experience, my involvement and participation plays a significant role in the learning of the entire group. I agree that if accepted, I will make a good faith effort to make attendance at these sessions a priority in my schedule. I verify that I am not currently running for office nor an elected official, nor will be during the ATC sessions. (Please email programs@newpoliticsacademy.org if you are running.) I agreeI do not agree

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