DTD Academy Executive Leadership Program Student Registration/Profile Form

Student Registration Form

Fill out the form carefully for registration
Which DTD Sports Leadership Program pathway interests you?
Parent/Guardian Name*

First NameLast Name
Student Name*

First NameMiddle NameLast Name
Student Birth Date*

MonthDayYear
Gender*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent Email*
example@example.com
Student Email*
example@example.com
Mobile Number*
Phone Number*
Work Number*
Student's Questions
How are you currently preparing for the real world expectations?*
Do you feel like you know how to navigate life on your own at this point in time?*

YesNoMaybe
What is your largest barrier in keeping you from being successful in life?*
How do you manage your time effectively? If not, in what area do you feel you may need assistance?*
What are you most passionate about? Why?*
Share your hobbies and what do you enjoy most about them? *
What are your post secondary plans beyond high school? How will you achieve your goals? What do you think is keeping you from succeeding in life and fulfilling your dreams? *
What motivates you to get up and start your day? How do you get your day started when you don't feel like being bothered?*
Describe your current life's blueprint and what variables did you consider when you created it? Is it working or not? Why? If unsure write N/A*
What do you think you can contribute to this program?*
What do you hope to gain from this program?*
Upload Current Professional Photo & Resume plus Digital Portfolio (if applicable)

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Student Registration Form

Student's Questions