Global Leadership Certificate Application
Thank you for your interest in the World Affairs Council's Global Leadership Certificate!

To be officially accepted into the Certificate program, students must complete the following application. Please note, a parent/guardian is required to sign the Certificate Terms Agreement, Liability Release, and Media Waiver.

Please download the Certificate Terms Agreement, Liability Release, and Media Waiver at https://tinyurl.com/GLCForms.

To submit this document, please scan or take a photograph and upload the file(s) at the end of the form. You can also mail a signed copy to:
World Affairs Council of Pittsburgh
c/o Kathleen Newell
2640 BNY Mellon Center
500 Grant Street
Pittsburgh, PA 15219

After you submit this application, you will receive a confirmation e-mail from the World Affairs Council within a few days.

If you have any questions concerning the Global Leadership Certificate, please contact Annie Prucey or Kathleen Newell at certificate@worldpittsburgh.org or 412-281-7970. Thanks!

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First Name *
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Last Name *
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Your Email Address *
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City *
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Age *
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School Name *
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Grade during the 2018-2019 School Year *
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Current Grade Point Average *
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Name of Teacher Sponsor *
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Name of Parent/Guardian *
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Parent/Guardian Email Address *
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Parent/Guardian Telephone Number *
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World Language Course and Level *
Ex. French II
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Please list all high school Social Studies classes taken (including current) *
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