JomLEAD Application (July Module)
We are SO GLAD that you will be joining us for the launching of JomLEAD this coming July! We are EXCITED about the FUN we will all have together, but also the opportunity for ALL of us to grow as leaders, to grow in understanding ourselves and in learning how to team together. It will also be a great opportunity for some of you to practice speaking in English! :-)

We trust most of you have already seen an overview of JomLEAD! at https://sites.google.com/view/jomlead/

JomLEAD at a Glance:

* Must be 11-13 years old (Note: Students must have basic conversational English ability.)
* Eight weeks (July 24 - Sept 11) meeting on Saturday afternoons (3:00-4:15pm)
* Cost is Rm 120 (50% Discount) - Each session only Rm 15 (usually Rm 30).
* Facilitated by GSP American Staff
           (www.gspconsulting.com / https://ultimatemalaysia.com/)
* Questions: Contact JomLEAD Coordinator, Derrick Wilkerson
           (DerrickW@gspconsulting.com / WhatsApp - +6011.1630.6009)

Once you complete the application, you will receive an email from JomLEAD with instructions for payment (Rm 15 x 8 sessions = Rm 120).

                          NOTE: APPLICATION DEADLINE IS *EXTENDED TO WED, JULY 21st, 2021.
                                         PAYMENT DUE BY THURSDAY, JULY 22nd, 2021
                                  NEW DATE OF SESSION ONE: SATURDAY, JULY 24TH, 2021

                   *TO ACCOMODATE REQUEST BY PENANG SCHOOLS TO SEND PARTICIPANTS


PARENTS, WOULD YOU BE SURE TO INCLUDE YOUR STUDENTS IN THIS APPLICATION PROCESS? We hope that both parents/guardians and students understand all about JomLEAD! and are excited about your participation in this pilot project! (Parents, we will only communicate with your students via email and you will be cc'd on any email communication with your students).
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1. Name of Parent / Guardian?
2. Email of Parent / Guardian? *
3. Phone of Parent / Guardian?
4. Full Name of Student (as in IC or Passport)? *
5. Email of Student?  
6. What would you (student) like all of us to call you (nick name)? *
7. Gender of Student? *
8. Student Date of Birth? *
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DD
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YYYY
9. Name of Student's School?   *
10. Student's year in school (grade) are you (ie Form 1 / Grade 7, etc)? *
11. Location of Student's School (name of city)? *
12. (For Student) What are a few words your friends would use to describe you (you can't say "cool!")? *
13. (For Student) What is something in your life that you think you might need to improve - or an area to grow in? *
14. (For Student) Why are you joining JomLEAD? What do you hope to get from it?
15. (For Student) Is there anything that you are a bit nervous or concerned about in joining JomLEAD? *
16. (For Student) Is there anything else that you think might be helpful for us to know about you?
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