2020 Leadership For Life Application
The 2020 Leadership for Life Summer Program is a work-based career and leadership development program for students in grades 7th thru 11th. The program will instruct, guide, and put into practice the skills needed to join the workforce. In addition the students will participate in community projects to increase their awareness as leaders and stakeholders within the South Chattanooga Neighborhood. Students will be paid a stipend at the end of the program.
Status: Summer Work Based Learner
Dates: Monday, June 08, 2020 – Thursday, July 16, 2020
Time: 8:30 a.m. – 3:00 p.m.
Pay: $100 upon completion of the program
Location Westside Missionary Baptist Church, 4001 Hughes Avenue, Chattanooga, TN 37410.
Meals Breakfast and lunch provided by the YMCA Supplemental Food Program. Students are welcome
to bring their own meals and snacks.
*Must demonstrate excellent written and verbal communication skills when interacting with students,
parents, guests and staff.
*Must comply with the program policy and procedures.
*Must be able to get to work ON TIME!
*Completion of all parent forms is required if under the age of 18.
*Must be able to attend all training sessions.
*Assist with any other duties as assigned.
Must be a rising seventh (7th) through rising tenth (11th) grader.
Talking and standing for prolonged periods, stooping and bending are required. Must be able to participate in
all program activities.
Health and Safety
Due to the recent coronavirus pandemic we have included our Health and Safety Guidelines to ensure that we
are taking the proper steps to maintain a safe and healthy environment for all program participants. The
information is included at the end of this application.
The following items are required to be considered for this program:
-Fully completed application with signatures
-Completed Liability and Release Forms
Please return the completed application to the address above or via email at
. For more information email or call us at (423) 401-0503.
Date of Birth
Are you a United States Citizen
Current Address (Include City,State, Zip)
What school will you attend for the 2020-2021 school year?
What grade will be be in for the 2020-2021 school year?
Name of Legal Guardian(s)
Relationship to Guardian(s)? (Mother, Father, Grandparents, etc.)
Emergency Contact (Please include Name, Phone Number, and relationship to contact)
Employment/Volunteer History (List your last two jobs and/or volunteer experiences, if you do not have any please put N/A in the fields)
Character References (Please list two character references, they cannot be relatives). Please list their name, phone and/or email. (Be sure to let them know that we may be contacting them). If you don't have references please put N/A in the box.
Criminal History: Have you ever been convicted of a/any crime(s)?
If you answered yes to the above question please provide the name and date(s) of the crime(s)
Have you ever been convicted in any criminal situation involving physical or sexual abuse of another person? If yes please explain.
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