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Ё`БрОВрОГрОДрОБ┐└┬╦Ь1 ДрОЕрОЖрОЗрО┐"ё`┐   @B АВ┐ └┬  ? @B:Ё Js3 $~╕  ИR4 Ё∙:Ё h)ЁB Ё/  Ё`БрОВрОГрОДрОБ┐└┬╦рМ ДрОЕрОЖрОЗрО┐"ё`┐   @B АВ┐ └┬  ? @B:Ё Їk═  \▓ ИR4 \▓:Ё h*ЁB Ё0  Ё`БрОВрОГрОДрОБ┐└┬╦Ь1 ДрОЕрОЖрОЗрО┐"ё`┐   @B АВ┐ └┬  ? @B:Ё Їk═  Ё∙ ИR4 Ё∙:Ё h+ЁB Ё1  Ё`БрОВрОГрОДрОБ┐└┬╦Ь1 ДрОЕрОЖрОЗрО┐"ё`┐   @B АВ┐ └┬  ? @B:Ё Їk═  l╕ Їk═  фD:Ё h,ЁB Ё2  Ё`БрОВрОГрОДрОБ┐└┬╦Ь1 ДрОЕрОЖрОЗрО┐"ё`┐   @B АВ┐ └┬  ? @B:Ё ИR4 Ё∙ ИR4 фD:Ё h-ЁB Ё3  Ё`БрОВрОГрОДрОБ┐└┬╦Ь1 ДрОЕрОЖрОЗрО┐"ё`┐   @B АВ┐ └┬  ? @B:Ё Їk═  и^& ЄЬ4 и^&:Ё h.ЁB Ё4  Ё`БрОВрОГрОДрОБ┐└┬╦рМ ДрОЕрОЖрОЗрО┐"ё`┐   @B АВ┐ └┬  ? @B:Ё Їk═  фD ИR4 фD:Ё h/CHNKINK >°<TEXTTEXTHSTSHSTSHHSTSHSTSHf╕STSHSTSH<FDPPFDPPFDPPFDPPFDPPFDPP FDPCFDPC"FDPCFDPC$FDPCFDPC&FDPCFDPC(FDPCFDPC*FDPCFDPC,FDPCFDPC.FDPCFDPC0FDPCFDPC2FDPC FDPC4SYIDSYID6 SGP SGP 6 Welfare Rights Initiative Hunter College, E1222 695 Park Avenue New York, NY 10065 (212) 650-3569; FAX: (212) 650-3845 www.wri-ny.org Application For Leadership Seminar Leadership Seminar Personal Information Name: Date: Age: Student ID Number: Languages: Home Address: City, State, Zip: Phone Number(s): Email: Age of Children: Student Status Please Check: rFreshman rSophomore rJunior rSenior Credits-to-date: Expected Date of Graduation: Number of Credits You Plan to Register for in Fall,  08 Semester: Major, if known: Grade Point Average: Career Goals/Plans After College: Please List Any College or Community Activities/Clubs/Actions of the Past 2 Years: Experience With Public Assistance Please Check to Indicate Status: r Current Recipient; For _____ Years; Head of Household: ryes nor r Former Recipient; For _____ Years: Year Terminated: r TANF (AFDC); r SN (HR); rOther, please specify: How did you hear about this program? Please indicate your availability to fulfill WRI scheduled requirements: r Yes, I can attend the seminar, Wednesdays from 10:10-1pm in HW 424, Fall 2008 r I am also planning to enroll in the WRI internship for the Spring, 2009 semester; r In addition, I m available for special events held on Wednesdays, 1-3pm; r Finally, I will be able to attend the minimum required 4 outside meetings this Fall. Please tell us when you can attend welfare organizing or advocacy meetings this Fall (1 to 3 meetings per month in addition to the weekly seminar): r I can be available 9:30 - 11:30 AM these days: M T W TH F S r I can be available 1:00 - 3:00 PM on these days: M T W TH F S r I can be available 2:30 - 5:00 PM on these days: M T W TH F S r I can be available after 5 PM these evenings: M T W TH F S Please write a short essay explaining why you d like to enroll in WRI s Community Leadership program and what you hope to gain from your participation in it: How did you hear about this program? Please indicate your availability to fulfill WRI scheduled requirements: r Yes, I can attend the seminar, Wednesdays from 10:10-1pm in HW 424, Fall 2008 r I am also planning to enroll in the WRI internship for the Spring, 2009 semester; r In addition, I m available for special events held on Wednesdays, 1-3pm; r Finally, I will be able to attend the minimum required 4 outside meetings this Fall. 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