LeadUS Mentoring Program 2015-16

HIGH POINT 101 ACADEMY APPLICATION
Personal Information
Name

First NameLast Name
Date

MonthDayYear
Date
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Format: (000) 000-0000.
Demographic Information
Gender Identity

Other
Date of Birth

MonthDayYear
Date
Are you currently a resident of the City of High Point?
How long have you lived in High Point?
Employment
Employer
Job Title / Occupation
Civic Engagement Questions / Community Involvement
Please describe any community organizations, volunteer activities, or civic groups you are currently involved in.
Why are you interested in participating in the High Point 101 program?
How do you plan to use the information gained from this program to benefit your community?
Are you interested in serving on a City of High Point board or commission?
Optional upload to supplemental documents further outlining your interests in participating in High Point 101 or your interest in serving on a board or commission

Cancelof
Program Commitment
High Point 101 participants are expected to attend most program sessions. Sessions are generally held during the evening hours and may include occasional Saturday activities. Are you able to attend evening sessions?
Are you able to attend occasional Saturday sessions?
PROGRAM SCHEDULE & ATTENDANCE EXPECTATIONS
High Point 101 particiapants are expected to attend and actively particiapte in program sessions throughout the duration of the academy. Sessions are generally held during evening hours, with select weekend activities.

Thursday evening sessions include:
- Dinner: 5:30 PM
- Program Session: 6:00 PM - 8:30 PM
- Saturday session times are TBD but will begin during the morning or early afternoon
The 2026 High Point 101 schedule includes the following dates:
- August 20
- August 27
- August 29
- September 3
- September 10
- September 17
- September 19
- September 24
- October 1
- October 3
- October 8
- October 22
- November 5
- November 16 - Graduation
Participants may miss no more than 2 of the 13 scheduled sessions in order to successfully complete the program.

Please review the schedule carefully before submitting your application.
Attendance Commitment
Certification
I certify that the information provided in this application is accurate. I understand that participation in the High Point 101 program requires attendance and active engagement.
Signature
Date

MonthDayYear
Date
Should be Empty:

HIGH POINT 101 ACADEMY APPLICATION

Personal Information

Demographic Information

Employment

Civic Engagement Questions / Community Involvement

Program Commitment

PROGRAM SCHEDULE & ATTENDANCE EXPECTATIONS

Certification