Youth Leadership Program Interest Form
I am a...
student interested in participating
adult interested in being a chaperone
Date of Birth
Contact Phone (if you have no phone, write N/A)
Contact Email (if you have no email, write N/A)
We are planning a lot of fun leadership activities this summer. Which ones are you interested in?
Ropes Course & OSU overnight trip (July 19-20)
Whitewater rafting & leadership skills day trip (late June)
Overnight camping & hiking trip (various dates throughout summer)
youth in STEM leadership conference (mid July)
Whale Watching Boat Tour & Beach Day (late June)
Indigenous Crafts & Native History Day Workshop (mid July)
service leadership beach cleanup day (July 5)
service leadership trail conservation day (tentatively July 12)
Personalized service leadership project (during the school year)
Do you have any other ideas for leadership activities that you would like to participate in?
Never submit passwords through Google Forms.
This form was created inside of NW Regional Education Service District.
Terms of Service