JULY 10 - JULY 16 DETROIT MICHIGAN

2011
The application with essay answers must be received by 5pm CAMPAIGN TO END AIDS/YAI 2011
February 1, 2011*. It can be faxed, mailed, or emailed using 727 15th Street NW Suite #210
the info provided and is available online at www.c2ea.org. Washington, DC 20005
You will be notified of your acceptance by March 1, 2011. Or fax to 202.408.1142.
If mailing your application, it must be sent a few days earlier For more information, please contact:
to assure it arrives by February 1, 2011. The Youth ACTION Kennda ‘Kail’ Burt - kali@c2eayouth.com
Tony Ray - tony@c2eayouth.com
Institute is open to non- U.S. residents. Carrie Rheingans - carrie@c2eayouth.com
*International applicants must submit by February 1, 2011, Contact C2EA Youth at info@c2eayouth.com
and notified of acceptance March 1, 2011. or 1877 END AIDS (363-2437).
Travel arrangements will be made once acceptance is confirmed.

To be completed by sponsoring organization(s):

ORGANIZATION NAME CONTACT PERSON/TITLE

ADDRESS By signing below I agree that my organization will sponsor and support this
applicant with fundraising and completion of the post-YAI project .
CONTACT SIGNATURE

PHONE DATE

Your Contact Information Emergency Contact Information

NAME NAME

PERMANENT ADDRESS RELATIONSHIP

PERMANENT ADDRESS

ALTERNATE ADDRESS

HOME PHONE WORK PHONE

E-MAIL

HOME PHONE WORK PHONE

Dietary/Other Requirements
E-MAIL
FOOD REQUIREMENTS / DIETARY RESTRICTIONS

Background Information
AGE GENDER OTHER REQUIREMENTS
(Male) (Female) (M2F) (F2M)

(Optional)
HIV STATUS RACE/ETHNICITY
Agreement and Signature
By submitting this application, I affirm that the facts set forth in it
Parent/Guardian (required if under 18) are true and complete.
PRINTED NAME PRINTED NAME

SIGNATURE DATE SIGNATURE DATE

1
 JULY 10 - JULY 16 DETROIT MICHIGAN
2011
Theapplication
The applicationwith
withessay
essayanswers
answersmust
mustbebereceived
receivedbyby5pm
5pm on CAMPAIGN TO END AIDS/YAI 2011
February 1, 2011*. It can be faxed, mailed, or emailed using 727 15th Street NW Suite #210
the info provided and is available online at www.c2ea.org. Washington, DC 20005
You will be notified of your acceptance by March 1, 2011. Or fax to 202.408.1142.

If mailing your application, it must be sent a few days earlier For more information, please contact:
to assure it arrives by February 1, 2011. The Youth ACTION Kennda ‘Kali’ Burt - kali@c2eayouth.com
Tony Ray - tony@c2eayouth.com
Institute is open to non- U.S. residents.
Carrie Rheingans - carrie@c2eayouth.com
*International applicants must submit by February 1, 2011.
and notified of acceptance March 1, 2011. Contact C2EA Youth at info@c2eayouth.com
or 1877 END AIDS (363-2437).

Pre-Conference
Pre-Conference Fundraising
Fundraising
All applicants
All applicants thatinvited
that are are invited to attend
to attend thethe conference
conference arerequired
are requiredto
toraise
raise $600 to help
help defer
defercosts.
costs.This
Thisis is
also a good
also way
a good for for participants
way
to get participants to get intoand
into the community the get
community and
a feel for getobstacles
the a feel for the
andobstacles
possibleand possible
setbacks setbacks
that that might
might occur whenoccur when planning
planning their project.
their summer
summer project.
Post-Conference Project
Post-Conference Project
As a participant you will be asked to partner with an AIDS Service Organization (ASO), community-based organization, religious institution,
As a participant
youth group, you will school
LGBTQ group, be asked or to partner
other withtoan
entity AIDSout
carry Service Organization
a grassroots (ASO), project
organizing community-based
that will beorganization,
carried out religious
during summer 2009 and
may beinstitution,
continued youth group,
after. LGBTQ projects
Organizing group, school
shouldor other
be linkentity
youth to carry outissues,
priority a grassroots
C2EAorganizing
demands project that will
(treatment, be carried
research, out
prevention & respect),
during
pressing summer
local needs 2010 and may be continued
and development after. Organizing
of grassroots networks. projects should link
We encourage youth priority
participants issues, C2EA
to develop demands
a project (treatment,
that is particularly relevant to
research, prevention
your community & respect),
surrounding HIV/AIDS. pressing local needs and development of grassroots networks. We encourage participants to
develop a project that is particularly relevant to your community surrounding HIV/AIDS.
In particular thin about the following questions:
In particular think about the following questions:
1. How is HIV/AIDS affecting you and your peers?
2. 1. What isWhat
yourdo you about
school HIV government
or local & AIDS? Howdoing does HIV
about& AIDS
it? affect you and your peers?
3. 2. What changes
What is your school
would youor local
like government
to see doingcommunity?
in your local about it?
4. 3. What gaps
Whatin changes
serviceswould
can you
youlike to seeininyour
identify yourcommunity?
local community?
4. What gaps in services can you identify in your community?
Essay Questions (use separate sheet of paper for answers)
Essay Questions (use separate sheet of paper for answers)
Please answer each of the following questions as completely and accurately as possible.
Please answer each of the following questions as completely and accurately as possible.
1. When did you first realize HIV/AIDS was something people fight against? What were the implications to you? (1-2 Paragraphs)
2. 1. What is
When
yourdid you first realize
experience HIV &volunteer,
(personal, AIDS wasor something people with
work- related) fight HIV/AIDS
against? Whatand were
have the
youimplications
participated to in
you?
any advocacy or activism
around(1-2
theParagraphs)
issue?
3. 2. What skills
What oris your experience
knowledge are (personal,
you hoping volunteer,
to gain byor work- related)
attending thewith HIVAction
Youth & AIDS and haveWhat
Institute? you participated
would be most in anyuseful to you organizing
aroundadvocacy
HIV/AIDS orin
activism around the issue?
your community? What does activism and advocacy mean to you?
(1-2 Paragraphs)
4. 3. PleaseWhat skills
outline or knowledge
a summer areyou
project you will
hoping to gain by attending
be committed the Youth
to carrying out forAction Institute?
at least two (2)What would
months be most
after useful to Include names
the conference.
you organizing
of organizations you around
plan toHIV & AIDS
partner in your
with, community?
fundraising plans,(1-2 Paragraphs)
and overall goals for your project.
5. 4. Are you
Please outline to
committed a summer project
continuing the you
workwillofbe committed
the Campaign to carrying out forpost
to End AIDS at least two (2) months
conference? aftercapacity?
To what the conference.
Include names of organizations you plan to partner with, fundraising plans, and overall goals for your project.
5. Are you committed to continuing the work of the Campaign to End AIDS post conference? To what capacity?

For more information, contact C2EA Youth at info@c2eayouth.com or 1877 END AIDS (363.2437).