United States Senate Youth Program (USSYP)2022-2023 Colorado Student Application

United States Senate Youth Program (USSYP)

2022-2023 Colorado Student Application

Applications Due: Wednesday, October 12, 2022, by 11:59 pm

For application and program questions, please contact:

Kim Burnham, Competitive Grants and Awards Supervisor

720-607-1495 | Burnham_K@cde.state.co.us

Submission Instructions:

Colorado student applications will be completed using the online application form. The online system does not save works in progress so applicants may wish to complete their information in the application template and copy responses into the online application.

Please ensure all required uploads are completed and ready to be attached when you begin the online form.

Complete all applicable fields in the form below and include the required attachments in the "Upload Required Documents" field at the end of this form.

All application materials can be found on CDE's Senate Youth Program webpage.

SECTION I: STUDENT AND SCHOOL DISTRICT INFORMATION

Student Name:*

Date of Birth*

Preferred Name

Preferred Pronouns

Student Telephone*

Student E-mail Address:*

Home Address*

Congressional District:*

Name of Parent/Guardian:*

Parent/Guardian Phone Number:*

Phone

Parent/Guardian E-mail Address:*

Name of Parent/Guardian:

Parent/Guardian Phone Number:

Phone

Parent/Guardian E-mail Address:

Student's Current Year in High School:*

Junior

Senior

Expected Graduation:*

Student Residency*

Per the United States Senate Youth Program rules, students must be a U.S. citizen or a legal permanent resident to apply to the program.

Student is a current U.S. Citizen

Student is a legal permanent resident of the U.S.

State Residency:*

Per the United States Senate Youth Program rules, the student is enrolled for the entire academic year in a public or independent high school located in the state in which at least one of their parents or guardians is a current resident.

Yes

SCHOOL AND DISTRICT INFORMATION

High School Name:*

School Address:*

[Street, City, State, Zip]

School District

School Phone:*

School Type:*

Public School (Includes Charters)

Private School

Principal Name:*

Principal E-Mail Address:*

QUALIFYING LEADERSHIP POSITION

What is the highest-level ELECTED OR APPOINTED qualifying leadership position that you will hold for the entire school year? Keep in mind being a founder or chairperson of a self-created club or organization DOES NOT qualify the student for the program.*

Provide a brief paragraph describing how you were elected/appointed/selected for this role. Describe the work you do to serve those you represent in this role.*

[Limit 150 words]

Provide a brief paragraph listing your leadership positions and academic honors, including community service, other extracurricular pursuits, and general plans for college and career in order of importance.*

Note: If selected as a delegate or alternate, this brief paragraph will be submitted with your participation information. [Limit 150 words]

Video Presentation

Address the question below in a brief video that is no more than three minutes long. You may use the platform that works best for you (YouTube, Vimeo, recorded from a device and shared via Google folder link, etc.). Important: please ensure that your video link is not set to “Private” and can be accessed by application reviewers.

Prompt:

Begin by saying your name and introducing yourself: “My name is ____________. I am a ____________ [Junior/Senior] at __________________ School.”

Please address: "If you were a Senator, what piece of legislation would you want to introduce, why is the issue important to you, and who would you work with as a colleague in the Senate right now to help you co-sponsor it?”

Provide the link to access your presentation in the space below.

Link to Video Presentation *

Upload Required Documents

Upload the following required documents:

Section II: School, Parent/Guardian, and Student Signatures

Ensure the form contains signatures from the guidance counselor official, parent/guardian, and student signature.
Save a copy of the completed form by naming your file in this format: LastName_Signatures.

Section III: Academic and Extracurricular Activity History

Save a copy of the completed form and name your file in this format: LastName_ActivityHistory.

Section IV: Student Essay

Save the completed essay in Word or PDF and name your file in this format: LastName_StudentEssay.

Section VI: Recommendations

Save your 3 recommendation forms in Word or PDF and name your file in this format: LastName_Recommendation1(2 or 3).

Note: the application’s required documents should be typed, whenever possible. Pages containing signatures should be scanned and included as part of the file uploads.

Please visit CDE's Senate Youth Program webpage for a detailed explanation of the application requirements.

File Upload*

Drag and drop files here or

Send me a copy of my responses

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