Peter E. Haas Public Service Leaders Program Application Thank you for your interest in the Peter E. Haas Public Service Leaders Program. Before submitting an application, please review the Peter E. Haas Public Service Leaders Program Commitments and FAQ sheets. The application closes at 11:59pm Friday, April 7, 2023. For current Haas Leaders: If you are seeking to re-apply for next year, please still complete Section I (Contact Information and Background). If your service project will change in focus from your original proposal, please complete section II (Short Essay Questions) prompts 1-4 to capture the change. We encourage transfer students new to the service landscape at Cal to consider serving with a community based organization through the Center’s Public Service Internships program. For open positions and program information, including program application, please visit the Public Service Internships website. The Public Service Center is committed to making our programs accessible to all students. If accommodations, including mobility accommodations, would make this program accessible to you, please email Aileen Pagdanganan at email@example.com any time before the application deadline. I. Contact Information and Background First Name (as it appears on your identification) Last Name (as it appears on your identification) Lived First Name Pronouns Email Non-Berkeley Email: Phone SID Expected Graduation Year Birthday (month/day/year) Are you a transfer student? –None–YesNo Are you a first-generation college student, meaning your parents, guardians, or grandparents did not attend college? –None–YesNo What is your major? African American StudiesAmerican StudiesAnthropologyArchitectureArt, History ofArt, Practice ofAsian American StudiesAsian StudiesAstronomyBioengineeringBusiness AdministrationCeltic StudiesChemical BiologyChemical EngineeringChemistryChicano StudiesCivil & Environmental EngineeringClassical CivilizationsClassical LanguagesCognitive ScienceComparative LiteratureComputer ScienceConservation & Resource StudiesDevelopment StudiesDutch StudiesEarth & Planetary ScienceEast Asian Languages & CulturesEconomicsElectrical Eng & Computer SciencesEngineering ScienceEnglishEnvironmental EconomicsEnvironmental Economics & Policy (CNR)Environmental Economics & Policy (L&S)Environmental Engineering ScienceEnvironmental Sciences (CNR)Environmental Sciences (L&S)Ethnic StudiesFilmForestry & Natural ResourcesFrenchGender & Women’s StudiesGenetics & Plant BiologyGeographyGermanGreekHistoryIndustrial Eng & Operations ResearchIntegrative BiologyInterdisciplinary Studies FieldItalian StudiesLandscape ArchitectureLatinLatin American StudiesLegal StudiesLinguisticsMass CommunicationsMaterials Science & EngineeringMathematicsMechanical EngineeringMedia StudiesMicrobial BiologyMiddle Eastern StudiesMolecular & Cell BiologyMolecular Environmental BiologyMolecular ToxicologyMusicNative AmericanNear Eastern StudiesNuclear EngineeringNutritional SciencePeace & Conflict StudiesPhilosophyPhysical SciencesPhysicsPolitical Econ of Industrial SocietiesPolitical SciencePsychologyPublic HealthReligious StudiesRhetoricScandinavianSlavic Languages & LiteraturesSocial WelfareSociety & EnvironmentSociologySouth & Southeast Asian StudiesSpanish & PortugueseStatisticsTheater, Dance & Performance StudiesUndeclaredUrban Studies What languages do you speak other than English? Gender (hold SHIFT to select multiple) Cisgender WomanCisgender ManTrans Woman/TransfeminineTrans Man/TransmasculineNonbinary/GenderqueerAgenderOtherDecline to State If you selected “Other”, or would like to provide details about your gender identity, please do so here. Racial or ethnic identity –None–American Indian/Alaskan NativeBi-Ethnic or Multi-ethnicAfrican/African-AmericanAsian/Asian-AmericanChican@/Latin@WhitePacific IslanderI do not identify with the above optionsDecline to State If you selected “I do not identify with the above options”, or would like to provide details about your race/ethnicity, please do so How did you hear about this program? –None–Public Service Center StaffPublic Service Center WebsiteClass PresentationDirect ReferralDrop-inEmailE-NewsletterFacebookFlyerGolden Bear OrientationOtherRecruitment FairWord of mouth Would you like to subscribe to the Public Service Center’s monthly newsletter that lists community events, service and leadership opportunities, scholarships, and more? The Public Service Center is committed to raising funds for those who need it. Please share your financial aid status with us to help us make this happen. (Please check all that apply.) Note: 65% of undergraduates receive some form of financial aid Not Eligible for Financial Aid Financial Aid Eligible Work-Study Eligible Pell Grant Eligible Please enter your Expected Family Contribution (EFC) listed on your CalCentral account or FAFSA/Dream Act. Note: You will be asked to submit a PDF of your financial aid information through a separate form at the end of this application. II. Short Essay Questions Peter E. Haas Public Service Leaders are expected to lead a service project that engages others in service for 10-12 hours per week through the academic year in partnership with an off-campus local organization. 1. Please describe your proposed project/engagement. Include what social justice or community issue you hope to address through your service and why it is important to you. 2. How do you plan to spend 10-12 hours/week in service to this project? 3. Who will you be in partnership with and accountable to for this work? How do you imagine building deeper relationships with local community organizations already engaged in this work? 4. Name the off-campus organization or community site you will partner with for 2023-2024. Please include name and contact information. 5. What kind of leadership skills do you hope to learn as an effective and impactful community leader in your service work? 6. How do your identities and lived experiences impact the way you show up in this world? What is your understanding of privilege and oppression as it relates to your lived experiences? 7. What are you hoping to gain by participating in the Peter E. Haas Public Service Leaders program? III. References Please provide contact information for two references, people who can speak to your leadership potential, commitment to serving the public good and ability to take on significant projects independently. References should not be peers or family members; at least one reference should not be a peer/student. Reference #1: Name, Title/Org, Email, and Phone Reference #2: Name, Title/Org, Email, and Phone IV. Additional Materials (Resume & EFC) IMPORTANT: All applicants are required to complete this form along with the application by March 24. Once you click the link, a new window will pop up directing you to upload additional materials through a google form that MUST be submitted along with this application. V. Application Checklist Please check all boxes below to confirm the following: I agree to fulfill all Peter E. Haas Public Service Leaders Program Requirements as detailed here. I have submitted the additional materials through this form. I have double-checked my application to ensure that all fields are completed and accurate, and true to the best of my knowledge.