Civic Voices Fellowship Application

First Name

Middle Name

Last Name

Email

Mobile Phone

Date of Birth

Gender

If other, how do you identify your gender?

Race

How would you describe your connection to public education as it relates to this Fellowship application?

Street Address

City

State

Zip Code

In which school district do you live?

Other School District

In which trustee district to you live?

Do you have children enrolled in a PreK-12th-grade public or charter school?

Please list what school(s) they attend

Do you have any interest in potentially running for a local school board or state board of education seat someday?

YesNoMaybe

Have you previously applied to Leadership ISD?

YesNo

How did you hear about LISD?

I am applying to join a cohort in:

Dallas CountyTarrant County

Employment

Are you currently employed?

YesNo

Current employer

Title/responsibility

Date started

Which category best describes your place of employment?

Street address

City

State

Zip Code

Volunteer & Civic/Professional Activities

Volunteer Activities

You may add up to 5 volunteer activities. Please be sure to include all service on boards, committees, etc.

Organization Name

Position

Dates

Responsibilities

Would you like to add another volunteer activity?

YesNo

Organization Name

Position

Dates

Responsibilities

Would you like to add another volunteer activity?

YesNo

Organization

Position

Dates

Responsibilities

Would you like to add another volunteer activity?

YesNo

Organization

Position

Dates

Responsibilities

Would you like to add another volunteer activity?

YesNo

Organization

Position

Dates

Responsibilities

Civic/Professional Activities

Awards/Recognitions & Date Received

Other Leadership/Advocacy/Education/Civic Training & Dates Attended (please also include if you are applying to other Fellowship programs for the 2022-23 year)

Other cool things you want us to know about your previous experiences

Free Response Questions

In this section we will ask you to respond to a series of short essay questions in 250 words or less. Would you prefer to answer in written form, or record an audio or video response?

WrittenAudio/Video

Instructions for audio/video recordings:

Please record yourself (on your phone or another device) answering all question in a single audio/video file. Be sure to read each question out loud on the recording before giving your response in 250 words or less.

Please name your single audio/video file containing responses to all questions listed below with your full name and the region you are applying for, i.e. "Jennifer Smith - Dallas County," and email it to apply@leadershipisd.org. Please put the region you are applying for and Civic Voices Fellowship in the subject line, i.e. "Dallas County Civic Voices Fellowship." Additionally, please be sure to add your full name to the body of text of your email and do not forget to attach your recording.

Free Response Questions:

1. What is your connection to public education and how does that influence what you want to accomplish through Leadership ISD?

2. From your perspective, what are the factors that impact student success, and what can you do to influence that change?

3. What parts of your identity have influenced how you have experienced or perceive public education?

4. From your perspective, how are racial equity and education connected? What do you see as your role in advancing racial equity in education?

We will review your application after receiving your submitted application form and corresponding audio/video recordings answering all essay questions. Please confirm you have submitted your audio/video responses via email by checking the box below prior to moving on with the rest of the application. If you have any questions, please email apply@leadershipisd.org.

I emailed a single audio/video file answering all questions to apply@leadershipisd.org with "*Region* Civic Voices Application" (Region = Dallas/Tarrant) in the subject line and my full name in the email body.

What is your connection to public education and how does that influence what you want to accomplish through Leadership ISD?

From your perspective, what are the factors that impact student success, and what can you do to influence that change?

What parts of your identity have influenced how you have experienced or perceive public education?

From your perspective, how are racial equity and education connected? What do you see as your role in advancing racial equity in education?

Fellow Commitments

Upon acceptance into the Fellowship, you are making a commitment to the organization, your fellow Cohort members, and the education community to fully participate in the program. Do you agree to the following commitments? More details about our Fellowship program can be found at leadershipisd.org/fellowship.

Attending monthly sessions, including orientation.

I agree to this commitment

Completing all pre-work assignments for every session.

I agree to this commitment

Committing additional time each month as part of your action team.

I agree to this commitment

Attending at least one school board meeting.

I agree to this commitment

Attending at least 3 school site-visits (optional for educators and students, format TBD with Covid-19 in mind).

I agree to this commitment

Complete at least one advocacy action including speaking at a school board briefing/meeting, publishing a piece of public opinion, or hosting a house meeting/community conversation.

I agree to this commitment

Tuition

Leadership ISD’s Civic Voices Fellowship is a leadership development program that provides the skills, mindset, and relationships needed to dismantle inequities in education and improve student outcomes. The Fellowship will increase your effectiveness as an advocate or prepare you for a higher level of leadership through board service.

Thanks to the generous support of foundations and individual donors, we are able to offer our Civic Voices Fellowship at a reduced tuition rate of $1,500. * We are committed to removing cost as a barrier to participation in our fellowship programs. Many employers use professional development funds to sponsor their employees participating in our programs. Additionally, Leadership ISD offers a limited number of need-based scholarships covering up to 80% of the full tuition rate. Current classroom teachers automatically qualify for a $500 scholarship.

I understand LISD's Civic Voices Fellowship is a tuition-based program.

Signature Page

By entering my initials below, I certify that the information in this application is complete and accurate. I read, understand, and agree to the Fellowship Commitments outlined.

Initials

Date

Your application is not complete until you press "Submit". Once an application is submitted, you will no longer be able to edit the application in any way.