Leadership in Advocacy Program Nomination

December 18, 2020Susan FeldmanNews

This program will engage young leaders with other students, professional guests, and state legislators. Grades 9-12 only.

Please complete the following application to the best of your abilities.
Your Name*
First Last
Your School*
Grade Level*
Your Email*
Phone Number*
Please provide one reference who can speak to your skills and experiences as well as your motivation to be a part of this program. This should not be a family member or friend.
Reference Name*
First Last
Relation
i.e. Teacher, Counselor, Tutor, Advisor, Mentor, Program Staff, etc.
Reference Email
Reference Phone Number
Short Essays
Please submit a brief bio of yourself.*
Please include any current leadership experiences, organization involvement, and other skills and interests.
Why would you be good fit for the Leadership in Advocacy Program?*
What would you like to achieve as a result of being in this program?*
Please ensure the application is filled out entirely and your answers are proofread prior to submitting.