Leadership and Advocacy Campus Experience Application

The Leadership and Advocacy Campus Experience will serve approximately ten individuals who have an intellectual disability, age 16 and above, who are currently attending high school. The program strives to provide participants with an introduction to, and the opportunity to practice, self-advocacy skills, to learn what it means to speak up for themselves and others, and to begin to develop skills for leadership. The Leadership and Advocacy Campus Experience is scheduled for July 8 – 19, 2024, Monday through Friday, with no overnight or evening events. To assure the ability to benefit from this program we ask that you complete the following questions.

Basic Information

Scholars Full Name (first and last name):

Scholar Cell Phone:

Scholar Email:

Name of Parent/Guardian (first and last name):

Parent/Guardian Email:

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Additional Phone Numbers

Home Phone:

Cell/Alt Phone:

Work Phone:

Scholar Questions

How old is the scholar? (Must be between 16 and 20 years old):

Is the scholar independent in daily activities?:

Yes

No

If No, does the scholar have a personal attendant on a daily basis?:

Does the scholar have functional communication skills, with or without assistive technology?:

Is the scholar able to participate in group activities and benefit from the short term (10 day) group educational experience?:

Is the scholar able to independently navigate within the building to access restrooms and vending machines?:

Is the scholar able to accept feedback and direction from others and modify performance accordingly?:

Is there anything else we should know about your scholar that may impact their ability to safely and independently participate in this experience?:

LACE Summer Program Information

Is there a cost to the program?

Yes, the program will cost $300. The cost is so that we may cover the cost of lunches and materials for projects.

When will I know if my youth has been accepted for this experience?

Notifications will be sent out no later than June 5 with information on how to complete the registration.

How long will applications be accepted?

Since this is a limited program applications will close when ten participants have been identified. Others names will remain on a wait list in case of cancellations.

Are there other programs for individuals with Intellectual Disability at ASU?

Additional programs are in development and will be announced as start dates are confirmed.