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National Youth Impact Summit
Application Overview
Before you start, here is an overview of what to expect in this application. 1. Contact Information 2. Essay Questions 3. Letter of Recommendation 4. Parent Permission
How did you learn about the program?
(Required)
How did you learn about the program?
My teacher/school
Email from Close Up
Online
Other
teacher/school name
Other
Contact Information
Student Name
(Required)
First
Last
Student Email
(Required)
Phone
(Required)
Parent Name
(Required)
First
Last
Parent Email
(Required)
Phone
(Required)
School Name
(Required)
Address
(Required)
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
Grade for 2022-23 School Year:
(Required)
Grade for 2022-23 School Year:
9th
10th
11th
12th
Have you participated in a Close Up program or event?
Yes
No
Please list which Close Up program(s) or event(s) you have attended.
Financial Aid
Do you need financial aid in order to participate?
Yes
No
We offer a limited number of need-based scholarships to students with inability to pay full tuition. Please fill out the below fields to the best of your ability.
Gross Family Income (Line 7 of IRS Form 1040)
Total Number of Dependents (line 6d of IRS Form 1040 or 1040A
Are there any additional details we should consider?
Essay Questions
How have you been challenged to grow, both as a student and individual, in the last year? How has this influenced your academic interests?
(Required)
Please share why you are interested in this summer program and what you hope to gain from participating.
(Required)
What do you see as the biggest challenge facing young people today?
(Required)
Teacher Recommendation
A teacher recommendation is strongly recommended. You will be provided with a link to share with your teacher once you submit your application. Teacher recommendations should be submitted within a week of your application submission. Please check that closeup.org is whitelisted with your email provider to ensure you receive our emails (check your spam folder if you do not receive a confirmation email when you submit your application). Please reach out to us at programsupport@closeup.org with any additional questions.
Parent Sign Off
Consent
I, the parent or guardian, agree to allow my student to apply to the National Youth Impact Summit with Close Up in Washington, DC. I am aware that the tuition for this program is $2,750, not including transportation, and that my student will need to be available from July 22 - July 29, 2023.
Parent Initials
(Required)
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