Apply for the 2010 Leveraging Privilege for Social Change Jam

2010 Application Form

Important Note: Due to the small and personal nature of the event, this questionnaire is longer and more in-depth than most, because we want to get to know you better. Please share as much as you feel comfortable sharing. There is no min/max length for responses and no pressure. We only ask you to share what you feel is 'enough'. We will follow up with more questions or a phone call if we need more information. Also, please note that all of your answers, including your name and basic info, will be kept in full confidentiality.* Only the leadership team will have access to your application. The more the team learns about you, the more informed their decision about selection can be.

* Please note that if you are accepted, your name and bio will be shared with the other participants of your Jam just prior to the event. Following the Jam, we will put this information up on our yesworld.org website so that you can participate in the alumni community, unless you request otherwise. More info on this is below.

Complete Name: *

Nickname (what you prefer to be called, if different):

Organization or Organizational Affiliation (if applicable):

Website of Group (if applicable):

Street Address: *

City: *

State / Province: *

Zip / Postal Code: *

Country: *

Work Phone:

Home Phone:

Cell Phone:

Email Address: *

Birthday (Month/Day/Year): *

Age: *

How did you hear about the Jam? Please list sources by name.:

Who You Are

How do you identify? gender identity, ethnic background, sexual orientation, class, anything else that makes you who you are.:

What's your focus in the world currently? What things are you actively working on? Please be as specific as possible about whatever you do, why you do it, and the values behind it.:

What inspired you to want to make a positive difference in the world? Tell us some piece of your story.:

What are your questions right now? What's alive for you? What are your current places of challenge, growth, and excitement?:

Why do you want to attend the Jam (as opposed to a conference, workshop, meditation retreat, etc.)? How do you feel its principles will be valuable for you at this point in your life/work journey?:

An important part of the Jam is bridge-building across historic divides and amongst diverse communities.

Why is bridge-building relevant to your work and/or important to you personally at this time? Can you share about a time when you were a successful bridge-builder? Can you share about a time when bridge-building was challenging for you? :

Please give us a mini-bio (a paragraph version of your story) written in the third person (for example, using "she" instead of "I"). Talk yourself up! Include conributions you've made, any awards or accomplishments, organizations you've been involved with, etc.

This is the bio that will be shared with other participants of this Jam, and will be used for the YES! Website. (You can always modify it later.) :

Anything else you'd like to tell us?:

Naming Your Privilege

Please be as specific as possible. If monetarily -- what is the scale, and what is your level of access or control?; If through position – what is the position, how does that power live for you, and what does it mean?;

If through fame – how many people do you impact and how does fame play out for you?; If through education – what is your educational background, and how do you work with that?; etc.

We recognize that privilege is self-defined, and we encourage you to take the time and space to tell us what it means for you.:

We recognize that sharing about our power, influences and privileges (especially for those with monetary privilege) is not something our society encourages. Most of us have been conditioned to keep such things to ourselves. A core focus of the Jam is an exploration of our privileges and power, and the opportunities and/or challenges they provide. We have set no specific yardstick or measure for privilege, so the more you can share about how you see and experience it in your life, the more we can deepen these conversations at the Jam. In that context, and in full confidentiality, we invite you to tell us about your current sense of privilege/influence/power in as much detail as you feel comfortable sharing.

How have you been leveraging this privilege(s)? (giving away money, donating time, being a spokesperson for causes, or... ?) How else do you want to be leveraging your privilege(s)?:

What are a few issues or questions that you struggle with around this privilege, or these privileges? Where are you hoping to grow in your understanding your privilege(s)?:

Costs of Attending

Are you or your organization in a position to pay the $2,000 tuition? If not, how much are you able to contribute to the cost of tuition (and what amount of scholarship would you require)?:

We invite work trades as well. Are there other non-monetary ways that you might be in reciprocity with the Jam (any particular skills, other in-kind contributions, etc.)?:

If you are accepted, we will be following up with you to ask you about diet, housing, travel plans, etc. We want to be sure to meet your needs at the Jam.

Travel expenses are the responsibility of the participant, though we do arrange carpools from the airport.

Thanks so much for taking the time to fill out this long application! We'll be in touch as soon as we can.

Apply for the 2010 Leveraging Privilege for Social Change Jam

YES! Jam Alumni!

Jammer Alumni Login

Connect