Citizenship Clinic Application

Last Name:

First Name:

Preferred Name:

BYU Email Address:

Primary Phone Number (XXX-XXX-XXXX):

Undergraduate Major:

Undergraduate Minor(s):

Do you speak any languages other than English? (not required)

If yes, list each language and your level of proficiency (Basic, Conversational, of Fluent)

Do you have experience with TESOL (Teaching English to Speakers of Other Languages)?

If yes, Please describe (100 words or less)

Briefly describe your interest in working with the Belonging Citizenship Clinic and your plans to contribute to its work of creating greater belonging in our community. (150 words or less)

Is there anything else you would like us to consider? (150 words or less)

Submitting a current copy of your resume is encouraged but not required. You may submit a PDF of your resume here.