DAWN BAKER
PRESENTS
DAWN’S DAUGHTER LEADERSHIP ACADEMY
“A Premier Leadership Experience”
DATES: JUNE 13 – 17, 2016
LOCATION: SAVANNAH ARTS ACADEMY
“Don’t settle for the status quo. You’re better than that.
And while you’re at it, ignore boundaries because they
really don’t exist. Be obsessed with humanity. Blend
strategy and creativity. Take charge and ignite change.
You’re designed to think differently and do something
about it.”
“The Pursuit of Excellence is Better than Settling for
Mediocrity.”
~Become the BEST You~
Freshman and Sophomore Young Ladies…
* For additional information and applications, please see your counselor.
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DAWN BAKER
PRESENTS
DAWN’S DAUGHTER LEADERSHIP ACADEMY
June 13 - 17, 2016
(Quarterly One-Day Sessions during the months of September, December and March)
APPLICATION FORM
*Please return this application to your guidance counselor by Monday, April 4, 2016
Please type or print in ink.
______________________________________________________________________________
Personal Information
Name: Last ______________________ First __________________ Middle ________________
School ________________________________________________Grade _________________
Home Address _________________________________________________________________
City _______________________ State ________________________ Zip Code ____________
Parent(s)/Guardian(s) ____________________________________________________________
Telephone ________________________ E-mail ______________________________________
T-Shirt Size (Please Check)
Small
Medium
Large X Large XX Large XXX Large
Parent(s)/Guardian(s) Daytime Telephone (in case of emergency) _________________________
______________________________________________________________________________
Involvement
Please list your involvement in school and community activities, including any leadership
positions held and work experience during the past two years.
______________________________________________________________________________
______________________________________________________________________________
_____________________________________________________________________________
______________________________________________________________________________
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______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
General Information
1. Of the activities that you have listed, which one is most fulfilling to you? Why?
______________________________________________________________________________
______________________________________________________________________________
2. What do you consider your greatest strength? _______________________________________
______________________________________________________________________________
______________________________________________________________________________
3. What do you consider to be one of your weaknesses that you would like to change into a strength?
______________________________________________________________________________
4. List 5 words to describe yourself: _______________ ________________ __________________
_________________ ____________________
Explain Why.______________________________________________________________________
_________________________________________________________________________________
______________________________________________________________________________
________________________________________________________________________________
5. What are your top priorities in life? Why? ____________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
__________________________________________________________________________________
6. Explain what makes an effective leader. __________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________
_____________________________________________________________________________________
7. In what ways do you view yourself as a leader now? Explain._________________________________
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_________________________________________________________________________________
___________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
8. What will you do to make a difference and change the future? __________________________
____________________________________________________________________________________
____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
9. If your life suddenly changed for the worst today, (Example: You lost all of your family and friends,
or they all have turned their backs on you), after you have recovered from the shock, what would you do?
Be specific.
_____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
___________________________________________________________________________________
____________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
10. Why would you like to attend the Dawn’s Daughter Leadership Academy? _____________________
___________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
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ESSAY
Using an attached sheet of paper, please respond to the following question in 300
words or less.
***Please type your essay.
Topics (Please choose one.)
1).Who do you admire as a leader and why?
2).Who has inspired you the most in your “personal” life? Why?
(Choose someone whom you know personally. Do not write about celebrities,
sports personalities, historical heroes, etc.)
______________________________________________________________
***
References
You will need two (2) letters of Recommendation:
1. One from Your School Counselor, Principal, or a Teacher
2. One from a Responsible Adult Who Knows You Well (Example below)
Please give one reference form to your high school principal, counselor or teacher. Give the
other reference form to any adult who knows you well, other than parents, guardians or other
relatives.
(Examples: employer, coach, community leader, scout leader, minister, etc.)
*At least one reference must be from someone outside of school.
Please list names of your References:
1. Name of Reference #1(Principal, Counselor or Teacher) _____________________________
2. Name of Reference #2_________________________________________________________
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DAWN BAKER
PRESENTS
DAWN’S DAUGHTER LEADERSHIP ACADEMY
REFERENCE FORM
(2 copies are enclosed)
*Please give a copy of this form to each of your references.
*Please collect these forms from the individuals and return them (along with your
completed application and essay) to your guidance counselor by Monday, April 4, 2016.
*Please type or print in ink.
______________________________________________________________________________
This section is to be completed by applicant.
Name: Last _____________________ First ___________________ Middle _______________
Address
_____________________________________________________________________________
City _______________________ State __________________________ Zip Code ___________
Telephone ________________________E-mail Address _______________________________
*Two references for each applicant must be returned to Dawn’s Daughter Leadership Academy
Selection Committee. The comments will be used for selection purposes only.
______________________________________________________________________________
To the Reference
The person named above is an applicant for Dawn’s Daughter Leadership Academy. The
academy is a leadership program designed to nurture and enhance the skills of students who wish
to impact the future. The Leadership Academy offers students a rare opportunity to interact with
outstanding community leaders and explore interesting topics, workshops, and other valuable
experiences.
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GOALS
The goals of the Leadership Academy are to:













develop group leader and member skills
develop increased competence in leadership
develop increased competence in decision making
develop increased competence in group process
develop increased competence in inter- and intra-personal communication; and related social
skills
develop critical thinking skills
develop one's capacity for critical decision making
to enhance one's success-oriented behavior toward realizing maximum potential
to enhance one's capability for value, goal, attitude, intra-personal relations and social
consciousness decision-making
enhance students’ leadership and interpersonal skills through interactive workshops, seminars and
community service projects, which will enhance the development of young women and inspire
them to pursue excellence so that they may positively impact the world around them
to provide unique, life-changing programs and opportunities for young women to interact with
outstanding community leaders
empower young women to develop their leadership talents and apply their talents so that they
may become effective, ethical leaders and make a positive difference in their homes, schools,
workplace, community and society as a whole
to help each student to be a loyal and responsible citizen
~
*This Section to be Completed by your References:
Your prompt assistance is greatly appreciated.
*Please complete the following questionnaire and return to the student or to the guidance
counselor by Tuesday, March 15, 2016.
Name of reference
_____________________________________________________________________
Position/Title __________________________________________________________________
School/Firm/Organization/Company ______________________________________________
City ___________________________ State __________________ Zip Code _______________
7
Questionnaire
1. How long, and in what capacity, have you known the applicant? _______________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
2. How does the applicant exhibit the following?
Trustworthiness (Honesty, Integrity, Reliability, Loyalty)_____________________________________
____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Respect (Civility, Courtesy and Decency, Courtesy and Decency, Tolerance and Acceptance)
____________________________________________________________________________________
____________________________________________________________________________________
__________________________________________________________________________________
___________________________________________________________________________________
Responsibility (Accountability, Pursuit of Excellence: Diligence. Perseverance, Continuous
Improvement, Self-Restraint)
_____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Fairness (Process, Impartiality, Equity)__________________________________________________
___________________________________________________________________________________
____________________________________________________________________________________
_____________________________________________________________________________________
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_____________________________________________________________________________________
Caring (compassionate, concern for others )________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________
_____________________________________________________________________________________
Citizenship (Does her share to make her school and community better, Involved in community service
and community affairs, Is informed, Cares about the voting process, Obeys laws and rules, respects
authority, protects the environment, volunteers)
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________
_____________________________________________________________________________________
Maturity____________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________
Interaction with peers _________________________________________________________________
____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________
3. What other leadership qualities do you see in the applicant other than what has been listed above?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
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____________________________________________________________________________________
4. How do you think participation in this program will benefit the applicant?
___________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
5. Additional comments ________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Signature of Reference _______________________________________ Date __________________
10
DAWN BAKER
PRESENTS
DAWN’S DAUGHTER LEADERSHIP ACADEMY
REFERENCE FORM
*Please give a copy of this form to each of your references.
*Please collect these forms from the individuals and return them (along with your
completed application and essay) to your guidance counselor by Tuesday, March 15, 2016.
*To the Reference:
*Please type or print in ink.
______________________________________________________________________________
This section is to be completed by applicant.
Name: Last _____________________ First ___________________ Middle _______________
Address
_____________________________________________________________________________
City _______________________ State __________________________ Zip Code ___________
Telephone ________________________E-mail Address _______________________________
*Two references for each applicant must be returned to Dawn’s Daughter Leadership Academy
Selection Committee. The comments will be used for selection purposes only.
______________________________________________________________________________
To the Reference
The person named above is an applicant for Dawn’s Daughter Leadership Academy. The
academy is a leadership program designed to nurture and enhance the skills of students who wish
to impact the future. The Leadership Academy offers students a rare opportunity to interact with
outstanding community leaders and explore interesting topics, workshops, and other valuable
experiences.
11
GOALS
The goals of the Leadership Academy are to:













develop group leader and member skills
develop increased competence in leadership
develop increased competence in decision making
develop increased competence in group process
develop increased competence in inter- and intra-personal communication; and related social
skills
develop critical thinking skills
develop one's capacity for critical decision making
to enhance one's success-oriented behavior toward realizing maximum potential
to enhance one's capability for value, goal, attitude, intra-personal relations and social
consciousness decision-making
enhance students’ leadership and interpersonal skills through interactive workshops, seminars and
community service projects, which will enhance the development of young women and inspire
them to pursue excellence so that they may positively impact the world around them
to provide unique, life-changing programs and opportunities for young women to interact with
outstanding community leaders
empower young women to develop their leadership talents and apply their talents so that they
may become effective, ethical leaders and make a positive difference in their homes, schools,
workplace, community and society as a whole
to help each student to be a loyal and responsible citizen
~
*This Section to be Completed by your References:
Your prompt assistance is greatly appreciated.
*Please complete the following questionnaire and return to the student or to the guidance
counselor by Tuesday, March 15, 2016.
Name of reference
_____________________________________________________________________
Position/Title __________________________________________________________________
School/Firm/Organization/Company ______________________________________________
City ___________________________ State __________________ Zip Code _______________
12
Questionnaire
1. How long, and in what capacity, have you known the applicant? _______________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
2. How does the applicant exhibit the following?
Trustworthiness (Honesty, Integrity, Reliability, Loyalty)_____________________________________
____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Respect (Civility, Courtesy and Decency, Courtesy and Decency, Tolerance and Acceptance)
____________________________________________________________________________________
____________________________________________________________________________________
__________________________________________________________________________________
___________________________________________________________________________________
Responsibility (Accountability, Pursuit of Excellence: Diligence. Perseverance, Continuous
Improvement, Self-Restraint)
_____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Fairness (Process, Impartiality, Equity)__________________________________________________
___________________________________________________________________________________
____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
13
Caring (compassionate, concern for others )________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________
_____________________________________________________________________________________
Citizenship (Does her share to make her school and community better, Involved in community service
and community affairs, Is informed, Cares about the voting process, Obeys laws and rules, respects
authority, protects the environment, volunteers)
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________
_____________________________________________________________________________________
Maturity____________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________
Interaction with peers _________________________________________________________________
____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________
3. What other leadership qualities do you see in the applicant other than what has been listed above?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________
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4. How do you think participation in this program will benefit the applicant?
___________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
5. Additional comments ________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Signature of Reference _______________________________________ Date __________________
15
DAWN’S DAUGHTER LEADERSHIP ACADEMY
ATTENDANCE AGREEMENT FORM
*Please return this to your guidance counselor by Monday, April 4, 2015.
Please type or print in ink.
Name:_______________________________________________________________________
Your commitment to this exciting Leadership Academy involves participation on the following dates:
June 13, 2016
June 14, 2015
June 15, 2015
June 16, 2015
June 17, 2015
*Quarterly One-Day sessions: September, December and March (Dates to be announced)
*Students will be expected to attend each day of the academy and arrive on time.
____________________________________________________________________________
*We understand and agree to the attendance requirements listed above.
Student Signature ______________________________________ Date ___________________
Parent(s) Signature _____________________________________Date ____________________
*There will be video and photographs taken during the Leadership Academy. Please sign
indicating that you approve of being videotaped or photographed.
Student Signature ______________________________________Date ____________________
*There will be video and photographs taken during the Leadership Academy. Please sign
indicating that you approve of being videotaped or photographed.
Parent(s) Signature _____________________________________Date ____________________
16
DAWN’S DAUGHTER LEADERSHIP ACADEMY
Application and Supplemental Materials Checklist
*(For School Guidance Counselor and Leadership Academy Applicant)
*Please use this checklist to make sure that you have included all required materials.
Application and Supplemental Materials (all are required)
Essay (per instructions)
Two Letters of Recommendation. (See further instructions attached.)
*Please list names of your References:
Name of Reference #1 (Principal, Counselor or Teacher)
_______________________________________________________________
Name of Reference #2
_______________________________________________________________
Attendance Agreement Form
***Finalists will be notified by your school counselor and by Dawn Baker.
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