CLC Jr. Staffer Application
Cooperative Leadership Camp is a full week overnight camp for High School students from across our state. Teens from all parts of the state are sponsored to attend for free by their local cooperative. We can take between 50-70 teens for the program for optimal success and up to 5 Jr. Staffers along with the adults. The program is an experiential learning processes where the teens build a worker/owner tee shirt cooperative, elect a board, hire a general manager, design and produce tee shirts. They learn about the leadership, governance, and the 7 cooperative business principles during the entire process. The teams put together the 7 Principles Infomercials to perform, have a leadership awards banquet night and learn what it means to be a part of the greater good that cooperatives offer. The week also contains workshops from other cooperative industries including the agriculture sector, credit unions, retail and utilities. The objectives are to educate, connect and promote the cooperative way of doing business and provide a fun learning experience for the teens that are selected to attend.

Jr. Staffers are requirements are the following:
1. Ride the bus from one of the bus stops,
2. Have attended CLC as a teen
3. Be a High School graduate with at least a 3.2GPA
4. Be at least 18 years old
5. Pass a background check
6. Have a letter of recommendation for leadership capabilities from either school or their co-op


2018 Dates are June 18-22 at the FFA Center in White Lake, NC.

Email address *
Full Name (First, M.I., Last): *
Your answer
Date: *
Your answer
Address: *
Your answer
Phone: *
Your answer
Email: *
Your answer
Parent/ Guardian Name(s): *
Your answer
Parent/ Guardian Phone(s): *
Your answer
Have you attended CLC before? *
If you have not, you do not qualify to be a Jr. Staffer. If you have, what year did you go to camp? *
Your answer
Are you (or a member of your family) a current Co-op member? If yes, please name organization. *
Your answer
Are you (or your parents) a Credit Union Member, Electric or Telephone Co-op Member, or other Cooperative Member? If yes, please name organization. *
Your answer
High School: *
Your answer
School Address: *
Your answer
School phone: *
Your answer
Graduation final GPA: *
Your answer
Age:
Your answer
Please list your first reference (Full Name, Relationship, Company, Phone, Email Address). This can be a leadership or school reference.
Your answer
Please list your second reference (Full Name, Relationship, Company, Phone, Email Address). This can be a leadership or school reference.
Your answer
Please list information about a leadership or volunteer role in which you have participated. You must include applicable information such as; Company, Phone Number, Address, Supervisor, Role, and Responsibilities.
Your answer
Please list information about a leadership or volunteer role in which you have participated. You must include applicable information such as; Company, Phone Number, Address, Supervisor, Role, and Responsibilities.
Your answer
Why should you be chosen to be a Jr. Staffer at CLC? *
Your answer
DISCLAIMER AND SIGNATURE - I certify that my answers are true and complete to the best of my knowledge. If this application leads to a spot at CLC, I understand that false or misleading information in my application may result in my spot being given to another applicant.
Your answer
I certify the above: Teen Signature: *
Your answer
Signature of Parent/ Guardian: (form will be sent to parent to sign and send back)
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Emily Nail. Report Abuse - Terms of Service - Additional Terms