United States Senate Youth Program
Submitted to Signature School's Scholarship Committee by August 18, 11:59 p.m.
First Name
*
Middle Name
*
Last Name
*
Email
*
example@example.com
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Student Cell Phone Number
*
Please enter a valid phone number.
Home Phone Number
*
Please enter a valid phone number.
Age
*
High School Graduation Year
*
2025
2026
Are you a U.S. citizen or legal permanent resident of the United States? Note: Students who are not U.S. citizens must be in possession of their I-511/"Green Card" at the time of application to be eligible.
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Yes
No
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Cell Phone Number
*
Please enter a valid phone number.
Parent/Guardian Email
*
example@example.com
Second Parent/Guardian Name (optional)
First Name
Last Name
Second Parent/Guardian Email (optional)
example@example.com
Second Parent/Guardian Cell Phone Number (optional)
Please enter a valid phone number.
List the year-long elected or appointed leadership positions that you hold in student government, a national honor society, or a civic or educational organization for the current 2024-2025 academic year. Please indicate year(s) you held the position(s) and include advisor or contact name and email.
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List other offices, organizations, and activities in which you participate
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What are your future plans, goals, etc.?
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After having reviewed program requirements and regulations (see the Academic Advising Notes for links to the Brochure, USSYP Website, Indiana Bar Foundation USSYP Website), explain why you are a good match for the program. Please limit yourself to 250 words or fewer.
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Upload a one-page résumé.
*
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Please have a parent sign here affirming that, if advancing to Indiana's Top Ten, you will attend the Top Ten Interview Day, October 14, in Indianapolis and that you will participate in the all-expenses-paid Washington Week, March 2-9.
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