Clone of South Carolina Youth Leadership Forum Application 2025

1

First Name* This field is required.

2

Last Name* This field is required.

3

Birthday* This field is required.

Date

4

Parent/Guardian Name (if under 18 only)

5

Gender* This field is required.

Female

Male

Non-binary

Prefer not to say

6

Race/Ethnicity * This field is required.

7

Home Street Address* This field is required.Ex. 123 Oak Street

8

City* This field is required.

9

State* This field is required.

10

Zip Code* This field is required.

11

Email Address * This field is required.

Do not use your school email. Make sure you can check this email in the summer!

12

Phone Number* This field is required.

13

How do you want us to contact you?* This field is required.

Email

Phone

Mail

14

Primary Disability* This field is required.What is the main disability you have? [Ex. Autism, Blindness, ADHD, Etc.]

15

Other DisabilitiesWhat other disabilities you have if any?

16

Is one of your disabilities categorized as developmental or intellectual?* * This field is required.*This will in no way impact your acceptance, we just need it for reporting purposes.

Developmental

Intellectual

Neither

I don't know

17

Describe your disability (Give at least 3 details)* This field is required.

18

Will you require a Personal Care Assistant [PCA]?* This field is required.*This will in no way impact your acceptance. We regularly provide PCA care at YLF. Knowing ahead of time helps us plan and coordinate for those who need it.

Yes

No

Unsure

19

What does your disability mean to you?* This field is required.

20

Describe a time where having a disability made you proud?* This field is required.

21

What qualities does a leader have? * This field is required.Think about someone in your life that you consider to be a good leader. What makes them awesome?

22

Why do you want to come to YLF?* This field is required.

23

What is your proudest achievement?* This field is required.

24

What do you want the world to know about you?* This field is required.What makes YOU awesome?

25

Have you attended the SC YLF before?* This field is required.

Yes

No

26

Are you applying to be a delegate or peer staff?* This field is required.

Delegate: A delegate is new to YLF and has never attended before. A delegate is a representative chosen to attend the SC YLF because of their leadership ability. A delegate shows leadership skills in their community and is motivated to work with their peers to carry out new ideas.

Peer Staff: Peer Staff have attended at least one previous year. Peer staff will have responsibilities during the forum, and for that reason, they may not participate in activities in the same way they did as delegates. This is a learning experience for everyone, but peer staff get to work behind the scenes!

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What do you feel you learned while at YLF last year?* This field is required.

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How can you help other delegates feel included and empowered at YLF?* This field is required.

29

How did you hear about the South Carolina Youth Leadership Forum?* This field is required.

My friend

My teacher

My parent/guardian

An awesome Able SC staff member

An awesome AccessAbility staff member

An awesome Walton Options staff member

An awesome DD Council staff member

30

Would you like to hear about more ABLE SC and peer support events for youth with disabilities?Such as skill building workshops, peer supports, hangouts, etc.

Yes

No