Your Name (required)
Mailing Address
Home Phone
Cell Phone
Grade in School
School
School ID
Birthday
Your Email (required)
Who recommended you to the program?
How often do you check your email? DailyWeeklyMonthlyNever
What is the best way to contact you? EmailTextHome PhoneCell Phone
Are you willing to commit to attending all of the meetings? YesNoNot sure
Are you willing to commit to participating in Community Involvement events at least twice a semester as a Student Leadership member? YesNoNot sure
Are you willing to participate in different events (meetings, site visits, fundraisers, projects, etc.) as a representative of Student Leadership Program? YesNoNot sure
Do you currently volunteer in your community? YesNo
Would you be able to get to and from the Leadership meetings that are held at a central location? YesNoNot sure
What has been a valuable experience for you in your life?
What are your plans for your future? What motivates you?
Who do you view to be a leader in your community? Why?
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?
Student Signature (Please type your name)
Parent Signature (Please type your name)
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Application