Artis Yancey HBCU College Tour, 2016 Presented by
Waukegan Township & Partners Application for Consideration Student information Artis Yancey December 25, 1959 - March 19, 2014
Full Name: _____________________________ Home Address: ______________________________ Contact Numbers: Home:
_____________________Cell: ______________________
Facebook/Twitter/Instagram account names: ______________________________________________________ Email address: __________________________________ Gender:
M F (circle one)
Age: ________
Grade: ________
High School attending: _____________________________________ Extra Curricular Activities (include volunteer work): _________________________________________________________________________________________________ Known Allergies: _______________________________________________ Student ID number (Please provide legible copy of school ID) _______________________________
Please provide an answer, in ESSAY format, to the following questions: (be sure essay is typed, double spaced, 12 point font and no abbreviations) I. What do you expect to learn/gain from this experience? II. Why should you be selected for this opportunity?
Your completed application packet should include: Letter of recommendation from your high school Letter of recommendation from your church and/or community leader One page essay – no more than 500 words or ONE page, 12 point font, double spaced Completed Application for consideration Emergency Contact Information:
Name: ___________________________________________ Home address: _______________________________________ Relationship to student: ___________________________________________ Contact numbers: Home: __________________________ Cell: _____________________ Email address (if applicable) ____________________________________
Student’s signature___________________________ Date_______________ Parent/guardian signature____________________________ Date_______________
2016 Artis Yancy HBCU College Tour Friday, March 18th, 2016 — Sunday, March 27th, 2016
Departure (Friday, March 18th, 2016) Location: Park Place Senior Center 414 South Lewis Avenue Waukegan, IL 60085 Time: 6:00 pm (arrive one hour prior, for mandatory Student Check-In) Louisiana Colleges and Universities Grambling University - Grambling Southern University of New Orleans* - New Orleans Xavier University of Louisiana - New Orleans Dilliard University - New Orleans Sightseeing* George & Leah McKenna, Museum of African American Art New Orleans African American Museum of Art Florida Colleges and Universities Florida A&M University - Tallahassee Edwards Waters College - Jacksonville Bethune Cookman University - Daytona Beach Sightseeing* FAMU Essential Theatre - Tallahassee Museum of Florida History - Tallahassee Georgia Colleges and Universities Albany State University - Albany Clark Atlanta University - Atlanta Morehouse College - Atlanta Spelman College - Atlanta Sightseeing* Martin Luther King Jr. National Historic Site - Atlanta The APEX Museum - Atlanta Alabama Colleges and Universities Alabama A&M University - Normal Alabama State University - Montgomery Tuskegee University - Tuskegee Selma University - Selma* Sightseeing* Birmingham Civil Rights Institute - Birmingham Rosa Parks Museum - Montgomery Return (Sunday, March 27th, 2015)* Location: Park Place Senior Center 414 South Lewis Avenue, Waukegan, IL 60085 Time: 1:00 pm *Subject to changes and/or additions
Artis Yancey HBCU Tour 2016 Presented by Waukegan Township & Partners Dress Code policy Artis Yancey December 25, 1959 - March 19, 2014
Because you will be representing Waukegan Township & Partners, it is vital that you “look the part”. To ensure that everyone is DRESSED FOR SUCCESS, we have developed a guideline to assist you in determining what is and is not appropriate for most situations. Below are examples of ACCEPTABLE and UNACCEPTABLE options: Slacks that are similar to Dockers or Khakis and other cotton or wool, pants as well as dressy capris, and nice looking jeans and dress pants are acceptable. NO SAGGING PERMITTED. We will be visiting the southern part of the country, therefore, walking shorts, or shorts that are knee level, are appropriate. Sweatpants, exercise pants, Bermuda shorts, short shorts, leggings, and any spandex or other form-fitting pants would be considered inappropriate. Casual dresses and skirts, and skirts that are split at or below the knee are acceptable. Dress and skirt length should be at a length at which you can sit comfortably in public. Sun dresses, beach dresses, and spaghetti-strap dresses are ONLY appropriate if they are worn with a jacket, sweater or “shrug” . Short, tight skirts that ride halfway up the thigh are inappropriate. Mini-skirts, some skorts, are inappropriate. Casual shirts, dress shirts, sweaters, tops, golf-type shirts, and turtlenecks are acceptable attire. Inappropriate attire includes tank tops; midriff tops; shirts with potentially offensive words, terms, logos, pictures, cartoons, or slogans; halter-tops; tops with bare shoulders; sweatshirts, and t-shirts unless worn under another blouse, shirt, jacket, or dress. Conservative athletic or walking shoes, loafers, clogs, sneakers, boots, flats, dress heels, and leather deck-type shoes are acceptable. Thongs, flip-flops, slippers, are not acceptable. Makeup, perfumes and colognes should be in good taste, with limited visible body piercing. Remember, that some individuals are allergic to the chemicals in perfumes and make-up, so wear these substances lightly and tastefully. Hats are not appropriate during presentations and inside buildings. Head Covers that are required for religious purposes or to honor cultural tradition are allowed.
Artis Yancey HBCU College Tour Presented by
Waukegan Township & Partners Code of Conduct/Rules and Regulations
Artis Yancey December 25, 1959 - March 19, 2014
Students participating in this activity are expected to be the best example of good citizenship at all times and abide by all guidelines established for the college tour. I will represent Waukegan Township and its partners in a respectful manner, because I know it's a privilege to take this trip!!!! Students who are caught in the act of theft, vandalism, illegal drugs/alcohol, underage drinking, or involved in other inappropriate activities, shall be sent home at the student's expense. Realizing that all safety precautions will be taken, I exonerate Waukegan Township, its Partners, its participants and chaperones of any responsibility in case of accidents. In order to expedite treatment, I hereby give my consent for treatment of minor injury and medical emergencies. 1. I will respect ALL chaperones, bus drivers, students, and representatives at the schools and other locations we will be attending AT ALL TIMES. 2. I will be on the bus at the required time. 3. I will NOT fight, curse or have an inappropriate attitude while on this trip. 4. I will NOT run or horseplay in the hotels. 5. I will respect my roommates and their property 6. I will NOT leave the hotel without permission from the chaperones. 7. I understand that I am not able to leave with family members or friends, from other cities, but they are able to visit me at the hotel during appropriate times. 8. I will dress respectfully and appropriately during college visits and sites/attractions. 9. I will attend all gatherings and be fully attentive during all aspects of the tour. 10. I will abide by social media guidelines. 11. I will NOT use headphones, hands-free devices or listen to music during presentations. I realize that if I do, my property will be taken away until the end of the activity. 12. I will NOT snack during actual tours. I understand that doing so is considered disrespectful and thus, against the rules set forth by Waukegan Township and Partners. I have read this Code of Conduct understand and agree to adhere to it and all policies of the Waukegan Township. If I do not comply with one or all of the rules I will be sent home at my expense. No exceptions!!!!
Print Name
Student ID
Student Signature
Date
Phone Number and/or email address
Name
Relationship to student
Phone Number
Email address (if applicable)
Parent/or Guardian Signature
Insurance carrier/Group or plan number