LEAH Summer Internships Application Application: LEAH Summer Internships 2025 Step 1 of 7 – Pre Program Information 14% If you are uncertain which internship is the best fit for you, please scroll up to review the descriptions before making your selection.Please select which internship you are applying for:* LEAH Daly LEAH Knox Name* First Last Date of Birth*MMMM123456789101112DDDD12345678910111213141516171819202122232425262728293031YYYYYYYY20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Home Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Phone*What is your current gender identity? (mark all that apply): Girl/Woman Boy/Man Nonbinary Agender/No gender Questioning Prefer to self-describe: Prefer not to answer I don’t know what this question is asking Gender IdentityWhat are your pronouns?*What is your racial or ethnic identity? (mark all that apply)* American Indian or Native American (e.g. Navajo Nation, Blackfeet Tribe, Inupiat Traditional Government, etc.) Black or African American (e.g., Jamaican, Nigerian, Haitian, Ethiopian, African American, etc.) East Asian (e.g., Japanese, Chinese, Taiwanese, Korean, etc.) Hispanic or Latina/o/x/e (e.g., Dominican, Guatemalan, Colombian, Puerto Rican, etc.) Middle Eastern or North African (e.g., Lebanese, Iranian, Egyptian, Moroccan, etc.) Native Hawaiian or other Pacific Islander (e.g., Samoan, Guamanian, Chamorro, Tongan, etc.) South Asian (e.g., Indian, Pakistani, Bangladeshi, Sri Lankan, Nepali, etc.) Southeast Asian (e.g., Indonesian, Vietnamese, Thai, Malaysian, Singaporean, etc.) White or European (e.g., German, English, Italian, Polish, etc.) Prefer to self-describe: Prefer not to answer Prefer to self-describe:*Language (s) Spoken at Home [check all that apply]* Arabic Cape Verdean Creole Chinese English French Haitian Creole Japanese Portuguese Spanish Vietnamese Another language not listed above Language spoken at home*LEAH Youth are paid via stipend for their participation in the STEM Internship. This requires youth to have a U.S. Social Security number. Can you confirm that you have a U.S. Social Security number? If not, we will reach out to you with a possible alternative.* Yes I’m not sure, please reach out to me about alternatives EducationFull Name of your School*Is your school part of BPS (Boston Public Schools)? Yes No What is your expected graduation year?* 2026 2027 2028 Other What is your expected graduation year?*Are you currently 16 or will you be 16 by July 7th, 2025?* Yes No (If no, you are not eligible to be a LEAH Youth Leader at this time) Have you taken a high school biology class?* Yes No Parent/Caregiver InformationParent/Caregiver Type (Mother, Father, Grandparent, Legal Guardian, etc.)*If multiple, just list oneParent/Caregiver First and Last Name* First Last Parent/Caregiver Phone Number*Parent/Caregiver Email Address* What is the highest level of education completed by ANY parent or caregiver who lives with you?* Less than a high school diploma High school graduate or GED completed Some College, Associate degrees (AA, AS), or vocational degree Bachelor’s degree (BA, BS, AB) or more Don’t know How many people live in your household?* Relevant Experience & InterestsFor the following short answer questions, please answer with a minimum of 150 words each.How would you describe yourself?*After reading the summer internship descriptions, what are you most excited about? What are you most unsure/nervous about?*Please describe your interests in science, data science, and/or any other topics within STEM.*What are your future educational and career goals?*Please upload your resume here ((Note: we cannot accept .docx files. Please convert to .doc or .pdf). Drop files here or Select files Accepted file types: doc, pdf, xls, Max. file size: 100 MB. ReferencePlease provide one reference who is a current or former Science Teacher who is willing to complete a recommendation form on your behalf.Reference Name* First Last Reference Job Title (eg. Biology Teacher)*Reference School Email* School where Reference works*The recommendation form will be emailed to your reference and must be submitted by March 31st, 2025 at 10pm. Please note that the form will only be sent once you have submitted your full application. Time Commitment & SchedulingI understand that to be accepted into a LEAH Summer Internship, I must be able to participate fully.* I understand Do you agree to participate for the entire summer internship July 7th – August 8th, 2025?* Yes, I agree to participate for the entire summer internship No, I am unable to participate for the entire summer internship Do you agree to participate in five 2-hour STEM Events during the 2025-2026 school year? Yes, I agree No, I am unable to commit to participating in the five 2-hour STEM Events during the school year If interested, you will be matched with a STEM professional mentor during the 2025-2026 school year. Are you interested in participating in the mentor program? This involves monthly mentoring sessions from Fall 2025 to Summer 2026.* Yes, I’m interested Maybe, I’d like more information No, I am not interested If accepted, you are strongly encouraged to continue with LEAH in Summer 2026. LEAH staff would work with you to place you in a paid STEM-focused internship with a local Boston STEM organization. If this summer is successful for you, would you be interested in pursuing this opportunity?* Yes No Unsure, I’d like to decide later Please explain:Do you have any other commitments between July 7th – August 8th, 2025 (sports, another job, extracurricular activities or vacations)?* Yes Most likely, not sure when No Unsure Please list your exact commitments and/or vacation dates to the best of your knowledge.*Please list recurring scheduling conflicts in the following format: Day + Start/End Time: Activity (e.g. Mondays 4-7PM: babysitting; Wednesdays 10-1PM: Karate [every other week]. If none, type N/A.*Anything else we should know about your schedule? Interview InformationPlease select AT LEAST TWO of the following dates/times when you could attend an interview in-person at our office in Chinatown. If you cannot make it to one of our interview times we will contact you. (please select all that apply)* Tuesday, April 8th, 4pm-6pm Thursday, April 10th, 4pm-6pm Tuesday April 15th, 4pm-6pm Thursday April 17th, 4pm-6pm I am not available to attend any of the listed times How did you hear about this opportunity?* High School Teacher PIC Counselor School Summer Opportunity Fair(s) Extracurricular Activities A LEAH Staff Member LEAH’s website or social media A current or past LEAH Youth Leader My Boys & Girls Club My local YMCA Other How did you hear about this opportunity?For your application to be considered complete, your chosen teacher must separately submit a Recommendation form (which will be emailed to them when you submit your appliction). Your application will not be considered without this document.* I understand Do you promise that to your knowledge, the information you provided here is accurate?* Yes, I promise the information is accurate If you have any questions or concerns, please email the LEAH team at: leahproject@hria.orgNameThis field is for validation purposes and should be left unchanged. Pages: Page 1, Page 2