Artis Yancey HBCU College Tour, 2016 Presented by

Waukegan Township & Partners Application for Consideration

Student information

Full Name: _____________________________

Home Address: ______________________________

Contact Numbers: Home: _____________________Cell: ______________________

Facebook/Twitter/Instagram account names: ______________________________________________________

Email address: __________________________________

Gender: M F (circle one) Age: ________ Grade: ________

High School attending: _____________________________________

Extra Curricular Activities (include volunteer work):

_________________________________________________________________________________________________

Known Allergies: _______________________________________________

Student ID number (Please provide legible copy of school ID) _______________________________

Please provide an answer, in ESSAY format, to the following questions: (be sure essay is typed, double spaced, 12 point font and no abbreviations)

I. What do you expect to learn/gain from this experience?

II. Why should you be selected for this opportunity?

Your completed application packet should include:

Letter of recommendation from your high school

Letter of recommendation from your church and/or community leader

One page essay – no more than 500 words or ONE page, 12 point font, double spaced

Completed Application for consideration

Emergency Contact Information:

Name: ___________________________________________

Home address: _______________________________________

Relationship to student: ___________________________________________

Contact numbers: Home: __________________________ Cell: _____________________

Email address (if applicable) ____________________________________

Student’s signature___________________________ Date_______________

Parent/guardian signature____________________________ Date_______________

Artis Yancey

December 25, 1959 - March 19, 2014

Departure (Friday, March 18th, 2016) Location: Park Place Senior Center 414 South Lewis Avenue Waukegan, IL 60085 Time: 6:00 pm (arrive one hour prior, for mandatory Student Check-In)

Louisiana Colleges and Universities

Grambling University - Grambling Southern University of New Orleans* - New Orleans Xavier University of Louisiana - New Orleans Dilliard University - New Orleans

Sightseeing* George & Leah McKenna, Museum of African American Art New Orleans African American Museum of Art

Florida Colleges and Universities

Florida A&M University - Tallahassee Edwards Waters College - Jacksonville Bethune Cookman University - Daytona Beach

Sightseeing* FAMU Essential Theatre - Tallahassee Museum of Florida History - Tallahassee

Georgia Colleges and Universities

Albany State University - Albany Clark Atlanta University - Atlanta Morehouse College - Atlanta Spelman College - Atlanta

Sightseeing* Martin Luther King Jr. National Historic Site - Atlanta The APEX Museum - Atlanta

Alabama Colleges and Universities

Alabama A&M University - Normal Alabama State University - Montgomery Tuskegee University - Tuskegee Selma University - Selma*

Sightseeing* Birmingham Civil Rights Institute - Birmingham Rosa Parks Museum - Montgomery

Return (Sunday, March 27th, 2015)* Location: Park Place Senior Center 414 South Lewis Avenue, Waukegan, IL 60085 Time: 1:00 pm

*Subject to changes and/or additions

2016 Artis Yancy HBCU College Tour

Friday, March 18th, 2016 — Sunday, March 27th, 2016

Artis Yancey HBCU Tour 2016 Presented by Waukegan Township & Partners

Dress Code policy

Because you will be representing Waukegan Township & Partners, it is vital that you “look

the part”. To ensure that everyone is DRESSED FOR SUCCESS, we have developed a

guideline to assist you in determining what is and is not appropriate for most situations.

Below are examples of ACCEPTABLE and UNACCEPTABLE options:

Slacks that are similar to Dockers or Khakis and other cotton or wool, pants as well as

dressy capris, and nice looking jeans and dress pants are acceptable. NO SAGGING PER-

MITTED. We will be visiting the southern part of the country, therefore, walking shorts, or

shorts that are knee level, are appropriate. Sweatpants, exercise pants, Bermuda shorts,

short shorts, leggings, and any spandex or other form-fitting pants would be considered in-

appropriate.

Casual dresses and skirts, and skirts that are split at or below the knee are acceptable.

Dress and skirt length should be at a length at which you can sit comfortably in public. Sun

dresses, beach dresses, and spaghetti-strap dresses are ONLY appropriate if they are worn

with a jacket, sweater or “shrug” . Short, tight skirts that ride halfway up the thigh are in-

appropriate. Mini-skirts, some skorts, are inappropriate.

Casual shirts, dress shirts, sweaters, tops, golf-type shirts, and turtlenecks are acceptable

attire. Inappropriate attire includes tank tops; midriff tops; shirts with potentially offen-

sive words, terms, logos, pictures, cartoons, or slogans; halter-tops; tops with bare shoul-

ders; sweatshirts, and t-shirts unless worn under another blouse, shirt, jacket, or dress.

Conservative athletic or walking shoes, loafers, clogs, sneakers, boots, flats, dress heels, and

leather deck-type shoes are acceptable. Thongs, flip-flops, slippers, are not acceptable.

Makeup, perfumes and colognes should be in good taste, with limited visible body piercing.

Remember, that some individuals are allergic to the chemicals in perfumes and make-up, so

wear these substances lightly and tastefully.

Hats are not appropriate during presentations and inside buildings. Head Covers that are

required for religious purposes or to honor cultural tradition are allowed.

Artis Yancey

December 25, 1959 - March 19, 2014

Artis Yancey HBCU College Tour Presented by

Waukegan Township & Partners

Code of Conduct/Rules and Regulations

Students participating in this activity are expected to be the best example of good citizenship at all times and abide by all

guidelines established for the college tour. I will represent Waukegan Township and its partners in a respectful manner, be-

cause I know it's a privilege to take this trip!!!! Students who are caught in the act of theft, vandalism, illegal drugs/alcohol,

underage drinking, or involved in other inappropriate activities, shall be sent home at the student's expense.

Realizing that all safety precautions will be taken, I exonerate Waukegan Township, its Partners, its participants and chaper-

ones of any responsibility in case of accidents. In order to expedite treatment, I hereby give my consent for treatment of minor

injury and medical emergencies.

1. I will respect ALL chaperones, bus drivers, students, and representatives at the schools and other locations we will be

attending AT ALL TIMES.

2. I will be on the bus at the required time.

3. I will NOT fight, curse or have an inappropriate attitude while on this trip.

4. I will NOT run or horseplay in the hotels.

5. I will respect my roommates and their property

6. I will NOT leave the hotel without permission from the chaperones.

7. I understand that I am not able to leave with family members or friends, from other cities, but they are able to visit me at

the hotel during appropriate times.

8. I will dress respectfully and appropriately during college visits and sites/attractions.

9. I will attend all gatherings and be fully attentive during all aspects of the tour.

10. I will abide by social media guidelines.

11. I will NOT use headphones, hands-free devices or listen to music during presentations. I realize that if I do, my property

will be taken away until the end of the activity.

12. I will NOT snack during actual tours. I understand that doing so is considered disrespectful and thus, against the rules

set forth by Waukegan Township and Partners.

I have read this Code of Conduct understand and agree to adhere to it and all policies of the Waukegan

Township. If I do not comply with one or all of the rules I will be sent home at my expense. No exceptions!!!!

Print Name Student ID

Student Signature Date

Phone Number and/or email address

Name Relationship to student

Phone Number Email address (if applicable)

Parent/or Guardian Signature Insurance carrier/Group or plan number

Artis Yancey

December 25, 1959 - March 19, 2014