Legacy Application

BCRI’s Legacy Youth Leadership Program (LYLP) utilizes BCRI’s mission, collections, programs, and partnerships to engage area high school students in a series of training experiences and internship opportunities that will help them develop into lifelong learners, productive citizens, and community leaders.

The objectives of LYLP are to: (1) promote student confidence, self-esteem, character, and community involvement through active participation, and (2) involve students as leaders in project planning and implementation.

The 2025 submission deadline is 5:00 pm CT on Friday, February 14, 2025.

Apply to be a 2025 Legacy!

"*" indicates required fields

General Information

Name*

First Middle Last

Address*

Street Address Address Line 2 City ZIP / Postal Code

Email*

Phone*

Gender*

Pronouns*

Date of Birth*

Education Information

School Currently Attending*

Grade Level*

Homeroom Teacher

Alternative Classes (gifted, special ed. etc.)

Extra-Curricular Activities

Awards Recognition

GPA

Parent/Guardian Information

Parent's Name (1)*

Daytime Telephone*

Cell Phone

Parent's Name (2)*

Daytime Telephone*

Cell Phone

Signature

Applicant Signature

Applicant First and Last Name*

Date

Parent/Guardian Signature

Parent/Guardian First and Last Name*

Date

Student Information

Please type a 1-2 page double-spaced essay covering each of the following:

Check-off list: Due Friday, February 14, 2025

Check Off list (all documents required to complete application)*

Completed Application Form

Typed Essay

Transcript (sealed if mailed or dropped off)

Letter of recommendation (sealed if mailed or dropped off)

Questions?

Upload Transcript

Max. file size: 8 MB.

Upload Letter of Recommendation

Max. file size: 8 MB.

Address and Contact

520 Sixteenth Street North Birmingham, AL 35203 Eboni Wallace - ewallace@bcri.org

Legacy Application

LEGACY APPLICATION