2022 Youth Leadership Application
Through our Summer Youth Leadership & Development Program students 6th-11th grade are exposed to goal setting,community organizing, career & college prep, skill development including budgeting, how to impact & make social changes as a youth leader & best of all students are exposed to life outside of Holmes County and Mississippi through peer to peer youth exchanges & convenings.

The Summer Youth Leadership & Development Program is a 8 week hands on interactive summer camp filled with activities, workshops, trips & skill development sessions to ensure that all participants finish the program as leaders and agents of change. Upon completion of the 8 week program students will graduate as youth leaders & receive a stipend for their hard work & dedication.

Once completed we will follow up with you.
Sign in to Google to save your progress. Learn more
Name *
Address *
Grade *
Student Phone Number and Email *
Parent Name & Phone number *
Parent & Student must attend Orientation June 11 at 11:00 am *
If you are filling this application out for your child please list areas you would like to see improvement.
Students, What kind of activities and workshops are you interested in participating in in our youth summer camp.
At the end of our summer leadership camp we will be taking a field trip as well as providing all students who completed the program with a $350 stipend.
Clear selection
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy