Student Leader Application

Become a Student Leader: Put on the award-winning In One Instant film assembly at your school
YOU can be part of the most impactful Leadership Opportunity of the Year! Help combat the #1 Killer of US Teens – distracted, impaired, and reckless driving.

You'll develop a variety of leadership skills when you implement the award winning, one-period In One Instant Film Assembly (or in-classroom presentation) at your high school. The program is peer-driven, designed to promote behavior change and save lives. You will Lead the Charge and become an Ambassador-for-Change in your community ... and we'll help you do it!

We provide all the tools you need to create an impactful and successful one-period Assembly or in-classroom presentation, while helping to develop your skills in event planning and public speaking. We:

*Teach you how to present to your school principal and your school.
*Have partnerships with Student Leader organizations that allow you to bring the program to your school at a reduced
fee or at no charge.
*Provide optional follow-up tools and community service opportunities to create long-lasting effect.
*You'll work together with a small committee of 3-5 peers, and one school staff member who will serve as Coordinator.
*You and your committee will prepare for the Film Assembly by using our step-by-step Student Leaders guide, connect
with the community, and help with any extra activities you choose to do.
*All tools are available in the Student Leader section of our website:

Our In One Instant Executive Student Council – comprised of a team of college student leaders, along with our staff, will provide guidance and answers to any questions along the way. Email:

Complete Student Leader Application below:
What do think? (Whatever you decide, complete the form anyway so we know how to follow up with you.) *
Name: *
Cell Phone: *
Home Phone:
Email Address: *
Current Grade Level: *
School Name: *
School City and State: *
Are you a member of our partner organizations, in leadership or volunteer? (such as HOBY, FNL, NOYS, etc)? If so, which one?
Thank you for your interest! We'll get back to you soon. One last question...Why is the topic of distracted, impaired and reckless driving important to you?
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