LDI Application | The Gamma Eta Lambda Chapter of Alpha Phi Alpha Fraternity, Inc.

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Before submitting this form; it should be reviewed by a legal parent/guardian.

The Leadership Development Institute offers qualified students a weekend of training in leadership development, civic responsibility, and professional preparation. Program activities have been planned to fulfill the following objectives:

To provide students with a diverse social and cultural setting that fosters academic and cognitive development, cultural awareness, and intellectual progress.
To expose students to various leadership opportunities and discuss pressing social, political, and cultural issues.
To equip students with significant leadership tools and life skills that will prepare them to become effective servant leaders.

This fee covers 1–on–1 Mentorship, Monthly Seminars & Activities, Personal Academia Assessment, SAT/ACT Preparation Camps, College Matching and enrollment support, Scholarship Identification, College and cultural experiences, Public Speaking, Financial Literacy beginning at the start of the program and persisting until the student’s high school graduation.

Application Registration Deadline – July 15th

Should you have any questions regarding the application, please contact the Director of Registration and Volunteers, via email at LDIsubmissions@austinalpha.com at any time. We look forward to building leaders and our community.

Student Name *

First

Last

School: *

Date of Birth *

GPA: *

Shirt Size *

Grade Entering:

Student's E-mail *

Additional Information

Student's Address *

Address Line 1

Address Line 2

City

State

Zip Code

Student's Phone # *

Parent/Legal Guardian *

First

Last

Parent/Legal Guardians Phone # *

Parent/Legal Guardians Email: *

Parent/Legal Guardian's Home Address

Address Line 1

Address Line 2

City

State

Zip Code

Parent/Legal Guardian

First

Last

Parent/Legal Guardians Email:

Parent/Legal Guardians Phone #

Address

Address Line 1

Address Line 2

City

State

Zip Code

Emergency Contacts

In case of emergency if the parents or guardians cannot be reached, please list two additional people we can contact. These may NOT be parents or guardians listed above.

Emergency Contact #1 *

First

Last

Emergency Contact #1: Relationship *

Emergency Contact's Phone Number *

Emergency Contact #2 *

First

Last

Emergency Contact #2: Relationship *

Emergency Contact's Phone Number *

Please list all individuals authorized to pick up your child: *

Allergies / Medical Concerns:

Please list any Allergies or medical concerns we should be aware of.

Briefly discuss your academic and/or career goals: *

Discuss why you wish to participate in the Institute:

What do you consider to be the most pressing issue facing young black males today?

What do you think can be done differently to address this issue and how can you or the Institute help in addressing this issue?

Please list any organizations that you are an active member of:

Hardship Waiver

Phone

Before submitting this form; it should be reviewed by a legal parent/guardian.

The Leadership Development Institute offers qualified students a weekend of training in leadership development, civic responsibility, and professional preparation. Program activities have been planned to fulfill the following objectives:

To provide students with a diverse social and cultural setting that fosters academic and cognitive development, cultural awareness, and intellectual progress.

To expose students to various leadership opportunities and discuss pressing social, political, and cultural issues.

To equip students with significant leadership tools and life skills that will prepare them to become effective servant leaders.

Should you have any questions regarding the application, please contact the Director of Registration and Volunteers, via email at LDIsubmissions@austinalpha.com at any time. We look forward to building leaders and our community.

Additional Information

Emergency Contacts