• Damien Center

    Positive Youth Action (+YA) Online Application

  • Our Leadership Development Program provides a fun, safe, and challenging experience for Youth and Young Adults aged 16-24 who are HIV-Positive or At-Risk to develop their leadership skills, explore potential careers in the HIV field, learn about the issues and challenges facing our communities, meet the leaders of the organizations working to address them, and learn how to participate.

     

    Applicants will be selected based on this application and an interview. Our goal is to create a group that will not only benefit from the experience, but will contribute to the development of the +YA program and to their communities.

     

    To apply, please answer each of the following questions as thoroughly as you would like. We are simply looking for an honest representation of who you are and why you want to work in promoting HIV Care, Prevention, and De-Stigmatization.

     

    If you have any questions throughout the process, please feel free to reach out to Nick Atkinson, Youth Program Specialist, at 317-632-0123 Ext. 168 or natkinson@damien.org.

     

    **PLEASE NOTE THAT THIS PROGRAM IS CURRENTLY ONLY FOR RESIDENTS OF INDIANA**

  • Demographics

  • What are your pronouns?*
  • What is your Date of Birth?*
     / /
  • Self-Attested disability status (does not require official diagnosis)?*
  • Format: (000) 000-0000.
  • Can you send/receive text messages?*
  • Current Enrollment or Highest Education Achieved:*

  • Emergency Contact Information

  • Format: (000) 000-0000.

  • Application (continued)

  • Do you know your HIV Status?*
  • Are you currently engaged in HIV Care or Prevention (such as PrEP)?*
  • Are you able to provide your own transportation?*
  • Participants must live in Indianapolis, IN, or have the ability to travel to Indianapolis roughly every-other-week to attend Cohort meetings. Individual schedule accommodations can be made when needed to account for work and life schedules by working with the Youth Program Specialist.*
  • Do you have the capacity to participate online? (If you do not have a personal device to access the internet, we may be able to assist you.)*

  • Expectations and Commitments

    Successful completion of the +YA program – and fully benefiting from it – requires individual participant commitment to:

  • Short-Answer Questions (1-2 Paragraphs)

    Just answer them as honestly as you can – we are simply looking for a representation of who you are and why you want to be a part of this Leadership Development Program.

  • Last Question!

  • If I am selected for an interview, it would be best to:*

  • Submission Page

  • Today's Date:
     / /

  • {whatIs}

     

    I understand that I may not be selected for this round of +YA, but that I can apply again for future cohorts. If I am not selected, it does not mean that I was not a good candidate, but simply that there were many applicants and only a select number (10) who can participate each cycle. If I am not selected this time and want to know how I could improve my application next time, I can contact the Youth Program Specialist, Nick Atkinson at natkinson@damien.org.

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