LEAP Program Home > LEAP Program (2025) > LEAP Program Scholar Application LEAP Scholar Track Application Application Deadline: 09-15-2025 "*" indicates required fields Δ Name* First Middle Name/Initial Last Address* Street Address Address Line 2 City StateAlabamaAlaskaAmerican 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 E-mail Address* How did you hear about the LEAP program: Social Media Friend or colleague Email Other Which social media? X Facebook LinkedIn BlueSky Other Degree(s)If applicable, please list your degree(s) below.Current PositionInstitution/Organizational Affiliation(If you are not currently employed or volunteering outside your role as a student, already listed above, please feel free to leave this question blank.)Current Student Status PhD/Doctoral Masters Bachelors Other Occupational Role/TitleField/Industrye.g., “Education”, “Technology”, “Healthcare”Gender* Male Female Gender Queer/Gender Non-Conforming Different Identity (please specify) Prefer not to answer Please specify*Race/Ethnicity (please select all that apply)* American Indian/Alaska Native Asian Black/African American Hispanic/Latino(a) Native Hawaiian/Other Pacific Islander White Other (please specify) Please specify*I was the first person in my immediate family to graduate from a four-year college.*TrueFalseHow would the JCOIN LEAP Scholars program meet your goals?*(ex. how does JCOIN S/I work into the projects you already have going on and/or have planned);Do you feel you have the time, based on your existing commitments, to commit to a monthly meeting and travel to the ACCJH and JCOIN SC meeting in your cohort year?*(If selected for the JCOIN LEAP Scholars program, LEAP will pay all/most of your travel expenses to these two meetings).Upload your resume/CVPlease include your CV/Resume in .txt, .doc, .docx, or .pdf format. Max. file size: 256 MB.Upload a short biography*Please upload a 150-word biography of yourself in .txt, .doc, .docx, or .pdf format. Max. file size: 256 MB.Upload your Reference(s)*Please upload a document with the name, title, and contact information of your reference(s) in .txt, .doc, .docx, or .pdf format. Max. file size: 256 MB.Upload your photoPlease upload your headshot photograph (optional). The file should be .jpg, .gif, or .png format and at least 450px. This will not be part of the review process and is not required. This is requested so we may publish scholarship recipients on signage at the conference.Max. file size: 256 MB.CAPTCHA
