2026~2027 Youth Leadership Academy Program Registration Form
Thank you for your interest in The Youth Leadership Academy Internship Program - 2026/2027. Please complete this registration form to apply for the Youth Leadership Academy Internship Program. This program is intended for youth ages 13-17, grades 7-11. Your responses will help us learn more about your background, interests, and eligibility.
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Email *
Full Name *
Date of Birth *
Applicants must be between 13 and 17 years old.
MM
/
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Grade Level *
Enter your current grade in school (7-11).
School Name *
Parent/Guardian Full Name *
Parent/Guardian Email *
Parent/Guardian Phone Number *
Applicant Email
Preferred Internship Focus Area *
Select the area you are most interested in exploring.
Why do you want to join the Youth Leadership Academy Internship Program? *
Describe any leadership experience, school clubs, volunteering, or community involvement.
Which skills best describe you?
Select one option per row.
Beginner
Developing
Proficient
Advanced
Communication
Teamwork
Problem Solving
Organization
Time Management
Confidence in Public Speaking
Clear selection
How did you hear about this program?
Anything else you would like us to know?
Submit
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