Application Form | Kramerica Gives

Name

First

Last

Address

Address Line 1

City

State

Zip Code

Home Phone

Cell Phone

Grade in School:

School:

Email Address:

Who recommended you to the program?

How often do you check your email?

Daily
Weekly
Monthly
Never

overcome your Date

What is the best way to contact you?

Email
Text
Home
Phone

Are you willing to commit to meeting at least twice a month as a Student Leadership member?

Yes
No

Are you willing to commit to participating in Community Involvement events at least twice a semester as a Student Leadership member?

Yes
No

Are you willing to participate at events (meetings, networking events, community service events, etc.) as a representative of Kramerica Gives Student Leadership Program?

Yes
No

What has been the most valuable experience for you in your life and why?

What are your plans for your future? What motivates you?

Who do you view to be a leader in your community? Why?

Which extracurricular activities are you involved with at school or outside of school?

What has been the biggest challenge you have had to overcome while in high school?

What are you most proud of or what is something really important to you?

Do you volunteer in your community? If yes, where and why? If no, why not?

Would you be able to get to and from leadership meetings at a central location? How do you plan on getting to the meetings?

Student Signature

Clear Signature

Date

Parent Signature

Clear Signature

Date

Student Leadership Application

Application