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Youth Project Application

Full Name

Date of birth

Address

Gender

City, State and Country

Phone *

Zip Code

Email *

Current School

GPA (if applicable)

Current Grade Level:

Youth Project you would like to join

Name of the Project *

Leadership Experiences

List any Leadership roles or positions you've held in school or your community:

Please describe project or initiative where you displayed leadership:

Essay Questions

What does leadership mean to you?

Why are you interested in attending this youth leadership workshop?

Community Involvement

Please list any community service activities or organizations you''ve been involved with:

Miscellaneous Information

Any special dietary restrictions?

Any medical conditions we should know about?

Certification

I certify that the information provided is accurate and true. I understand that any false information can lead to my disqualification from the workshop.

Applicant's Signature:

Date:

Parent/Guardian's Signature (if under 18):

Parent's /Guardian's Phone Number

I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business.

Thank you for your interest in the Youth Leadership Workshop! We look forward to reviewing your application.

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Contact

Email: [email protected]

Phone : (702) 957-7393

Address : Las Vegas, Nevada