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Youth Leaders Program
1
Name
*
This field is required.
Please share this form with the youth you would like to recommend.
First Name
Last Name
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2
Mobile
*
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Please share your mobile or a family member's mobile number
Please enter a valid phone number.
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3
School
name of your current/last school
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4
Age
*
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5
Grade
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6
Email
*
This field is required.
Please enter the youth's email here
example@example.com
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7
Would you like to help create a plan to improve youth opportunities?
*
This field is required.
YES
NO
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8
What is the best meeting time for you?
Please only choose the most convenient time
Weekdays @5p
Saturdays @ 11a
Saturdays @ 1p
Weekday @6:30p
Other please share below
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9
How would you like to participate?
Join leadership council
Lead meetings/discussions
Conduct research/manage data
Identify fun, learning activities/experiences
Attend youth leadership meetings
Answer surveys/provide feedback
Recruit other youth leaders
Help plan and produce events
Design branding and graphics
Capture photos and videos
Coordinate with participating adults
Other please share below
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10
Any questions for us?
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