Stetson Changemakers Academy

Applicant Information

First Name

Last Name

Email Address

Phone Number

Birthdate

Mailing Address

Country

Street

City

Region

Postal Code

Relation Information

Parent or Guardian First Name

Parent or Guardian Last Name

Parent or Guardian Phone Number

School Information

What High School Do You Attend?

Select Your Grade in Fall 2025:

Sophomore

Junior

Senior

Demographic Information

How do you describe your racial and/or ethnic identity/ies?

How do you describe your gender identity/ies?

What is your biological sex assigned at birth?

Male

Female

*Stetson's policy for participants under 18 years old is that, if roommates need to be assigned, they are assigned based on biological sex assigned at birth. Program staff are committed to ensuring that every participant has housing accommodations that meet their individual needs, so we’re happy to discuss any particular needs you may have related to housing assignments; contact us at <changemakers@stetson.edu>.

Short Answer Questions (In 300 Words or Less)

You can also respond to these questions in a visual, audio, or video format. Please contact us (changemakers@stetson.edu) for instructions to submit responses in those formats.

1. What are 2 problems, issues, or challenges in your school, community, or the US as a whole that you really want to see change? For each one, explain why you care about it and a change you want to happen with it.

2. Describe an example of a time when you stood up for what you believe in, helped others, or worked to make your community better. This could include experiences like volunteering, leading a school club, supporting a cause you care about, or how you’ve handled unfair situations in your life.

3. Who or what inspires you to make a difference, and why? How has this person, event, or idea shaped your outlook on leadership and social change?

Note: Consistent with Stetson University’s values, the Stetson Changemakers Academy celebrates demographic diversity among its participants, fosters an inclusive experience where everyone treats one another respectfully, and promotes social equity, which enables historically disadvantaged groups to participate as equals in society. By applying, you agree to act in accordance with these commitments if you are selected as a participant.

Signature

In place of your signature, please type your full legal name:*