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After School Leadership Camp Application - 5/6th Grade Girls - Aspen Middle School
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Email
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Today's Date
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Student's Full Name (First, Last)
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Address
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Cell Phone
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Age
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Date of Birth
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Parent(s) Full Names
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Emergency Contact Information
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List up to five (5) school-related or non-school-related activities in which you have participated during the last two (2) years. Please include: name of school/club/organization, dates involved and role in activity.
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What is your biggest challenge right now with friends at school or with family?
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Name three characteristics you value in other people.
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If you could spend a day with your hero or role model, who would you choose and why?
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Describe a talent or skill you have.
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How can you be a role model for younger children in your community?
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Describe a time when your actions positively impacted a person, your school or your neighborhood.
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Why do you want to be part of this program? What do you hope to get out of it?
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