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KEEP application
Name
  
Street Address
  
City, State, Zip
  
Home Phone
  
Work Phone
  
Email Address
  
Occupation
  

Date of Birth

  
On a separate cover letter, please answer the following questions:
  1. How did you hear about this program?
  2. How are you involved in your community?  Please provide the contact information for two people who can provide a reference regarding your activities.
  3. What specific issues are you interested in learning about and why?
  4. How do you hope to apply what you learn?
  5. What skills or abilities do you have to contribute during or after the program? Please note any language abilities, media, writing, artistic, fundraising, organizational skills, etc.
  6. Why do you want to participate in this program? 
  7. What are your long-term goals and how will participating in KEEP help you reach them?
  8. Will you require a low-income need-based subsidy to participate in KEEP?

Please send a current resume (or a short description of past activities) with this application to KEEP at ((keep(at)egroups.com)).   

The application deadline is March 31