Youth Leadership Academy Application

Youth Leadership Academy Application

Please fill out the form to apply for the Youth Leadership Academy. Sgt. Friesen will follow up with each applicant at the phone number provided.
Full Name

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Alternate Phone Number (If primary phone number cannot be reached)
Please enter a valid phone number.Format: (000) 000-0000.
Date of Birth

MonthDayYear
Date
What school do you attend?
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Why do you want to join the Youth Leadership Academy?
What does being a leader mean to you?
Do you have any volunteer or community service experience? If so, please list below.
What school activities are you involved in? (Sports, Extra Curricular's, Clubs, etc.)
Do you have reliable transportation to and from each session? *This is only to estimate how many mentors we will need to assist with transportation - your answer to this question will not determine your acceptance.*
Are you able to dedicate one day a month to Youth Leadership Academy (8am-3pm)?
Rules:

1. Respect Others

2. Be on Time

3. Dress Appropriately

4. Participate Fully

5. No Disruptive Behavior

6. Stay Substance-Free

7. Prioritize Safety

8. Honor Your Commitments

9. Ask for Help

*Failure to follow the rules is grounds for immediate dismissal.*
I agree to the rules listed above.
Signature
Should be Empty: