2025-2026 Cesar Chavez Ambassadors

Youth Leadership Program

APPLICATION

The César Chávez Ambassadors Youth Leadership Program centers on empowering high school students with the historical knowledge and principles of César E. Chávez. By mobilizing these youth as advocates for César Chávez Day of Service activities, especially the annual March for Justice, the program bridges the gap between history and contemporary social issues. Leadership cohorts, each comprising of 10 students from approximately 12 high schools, will convene monthly to learn about and discuss policy matters affecting the community. The program's uniqueness lies in its emphasis on developing actionable plans tailored to each school campus, ensuring a localized impact.

Program participants will meet once a month from October through May, and are expected to commit to the program by attending all mandatory classes and meetings, and complete 40 hours of volunteer community work.

FUNDING
The César E. Chávez Ambassadors operates at NO COST to the participants. All materials needed within the program will be provided to the participants.
Please Note: Transportation will not be covered for participants in the program.

ACADEMIC CREDIT
Academic or Community Service Credit may be available to you from your high school. César E. Chávez Ambassadors Program will provide proof of service at your request.

THE APPLICATION
To apply, please fully complete all sections below. Failure to provide complete answers may affect the review or consideration of your application.

SUBMIT APPLICATION OR ANY DOCUMENTS TO:
César E. Chávez Ambassadors Youth Leadership Program
C/O Pueblo y Salud, Inc.
1024 N. Maclay Ave., Suite M13
San Fernando, CA 91340
Phone: (818) 837-2272
Fax: (818) 837-2271
Email: [email protected]

First Name

Last Name

Date of birth *

Address

Residential Address *

City *

State *

Country *

Postal Code *

School Email Address *

Personal Email Address *

Phone *

Home Phone Number *

Name of High School *

Name of High School College Counselor *

Email Address of High School College Counselor *

Current GPA *

Are you a part of (Check all that apply)

Magnet

Honors

AP/ College Classes

Other

Extra Curricular Activities/ Clubs *

Previous Volunteer Experience *

Interests/ Hobbies *

PARENTAL CONSENT

We are requesting your permission for your student to participate in Cesar Chavez Ambassadors Youth Leadership Program. Please read the details below and submit this form to give or deny consent

PARENTAL CONSENT- (Digital Signature) If the student is under the age of 18, please ask your parent or guardian to type their name. If the student is not under the age of 18, they can sign themselves. "By typing my full name below, I confirm that I am the legal parent/guardian of the child named above and I give my consent as indicated." *

PARENTAL CONSENT *

PARENTAL CONSENT- Please type your parent or guardian's cell phone number *

PARENTAL CONSENT - Please type your parent or guardian's email address *

Pueblo y Salud, Inc.

César E. Chávez Ambassadors Youth Leadership Program is a project of Pueblo y Salud, Inc., a 501(c)(3) non-profit organization.

1024 N. Maclay Ave., Suite M13
San Fernando, CA 91340
Phone: (818) 837-2272
Fax: (818) 837-2271
Email: [email protected]