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University of Minnesota
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Camp Emerge Application 2021
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First Name
Middle Name
Last Name
Birthdate
Birthdate
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Email Address
Phone Number
Are you Hispanic or Latino?
Are you Hispanic or Latino?
Yes
No
Prefer not to answer
With which race or ethnicity do you identify?
With which race or ethnicity do you identify?
American Indian or Alaska Native
American Indian or Alaska Native - Enter your Tribal Affiliation (Optional)
Asian
Asian - Chinese
Asian - Hmong
Asian - Indian
Asian - Japanese
Asian - Korean
Asian - Pakistani
Asian - Filipino
Asian - Vietnamese
Asian - Other East Asian
Asian - Other South Asian
Asian - Other Southeast Asian
Asian - Other
Black or African American
Black or African American - U.S. / African American
Black or African American - African
Black or African American - Caribbean
Black or African American - Other
Native Hawaiian or Other Pacific Islander
Native Hawaiian or Other Pacific Islander - Guamanian
Native Hawaiian or Other Pacific Islander - Hawaiian
Native Hawaiian or Other Pacific Islander - Samoan
Native Hawaiian or Other Pacific Islander - Other
White
White - European
White - Middle Eastern
White - Other
We realize that the racial/ethnic category you selected encompasses many different nationalities. If you are interested in sharing more, please describe your nationality (i.e., Armenian, Puerto Rican, Vietnamese):
Which gender do you identify with? (Select all that apply)
Which gender do you identify with? (Select all that apply)
Agender
Gender non-conforming
Genderqueer
Man
Non-binary
Two Spirit
Woman
Prefer not to specify
Enter your own
Gender Identity - Other
Please select your preferred personal gender pronouns.
What are personal gender pronouns?
"A personal pronoun is the pronoun(s) a person uses for themselves and how others should refer to that individual" (
Source: University of Minnesota, Duluth
)
Why are personal pronouns important?
Using someone's correct personal pronouns is a way to respect them and create an inclusive environment, just as using a person's name can be a way to respect them (
Source:www.mypronouns.org
)
He/Him/His
He/They
None (Name only)
Prefer not to specify
She/Her/Hers
She/They
They/Them/Theirs
Ze/Zir/Zir
Enter your own
Personal Pronouns - Other
Do you identify as part of the LGBTQIA+ community?
No
Yes
Prefer not to say
Have you ever served in the US Armed Forces for any length of time?
Have you ever served in the US Armed Forces for any length of time?
Yes
No
Are you a First Generation College Student?
Are you a First Generation College Student?
Yes
No
Are you affiliated with any of the following community-based or professional organizations?
Are you affiliated with any of the following community-based or professional organizations?
Forte (Launch)
NBMBAA
ROMBA
Prospanica
Genesys Works
JumpStart
UpTurnships
None
Other
Community-Based or Professional Organizations - Other
Permanent Address
Permanent Address
Country
Street
City
Region
Postal Code
Is your permanent address different from your mailing address?
Is your permanent address different from your mailing address?
Yes
No
Mailing Address
Mailing Address
Country
Street
City
Region
Postal Code
College or University
Major
Graduation Date
Graduation Date
January
February
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April
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November
December
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2043
GPA
Resume
Please upload a copy of your most current resume.
In less than 500 words, please answer
both
of the following prompts. Please submit the essay in PDF format.
Tell us why you think Camp Emerge would be a good fit for you. Please frame your answer using your academic and professional goals, including your interest in graduate school.
What communities do you consider yourself to be a part of and what are the most pressing problems you believe your communities are facing? How will Camp Emerge equip you to be a leader in addressing those problems?
Submit