Student Leadership Board Application 2023-2024 (SW WA)
Student Leadership Board details: https://www.holocaustcenterseattle.org/learn/student-leadership-board
Note: This form is specifically for students in the Southwest Washington area. If you are in Seattle or Spokane, please refer to the SLB applications linked below.


Deadline to submit, for both new and returning students, is Friday, September 15, 2023.  Returning students in good standing will be prioritized and additional spots will be offered to new members. Spots are limited so please apply early, if possible. 

A reminder that as of the 2023-2024 school year, ALL SLB meetings will be held IN PERSON at a TBD location in Southwest Washington. These meetings will be every other week, in the afternoon, from October to May. By submitting this application, you are confirming that you will be able to attend these meetings on a regular basis. Failure to consistently attend will result in dismissal from SLB.

For more information or questions about the Southwest SLB, please reach out to Michael Ready and Robert Cozzi at michael.ready@kalama.k12.wa.us and robert.cozzi@evergreenps.org.
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E-Mail-Adresse *
Student's First Name: *
Student's Last Name: *
What are your pronouns? We ask so that we can address you as you would like to be addressed when we communicate. (Check all that apply.)
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Pflichtfrage
Are you a new or returning SLB member? *
Home Address (include city, state, zip):
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Phone Number:
 *
Is this your...
 *
What age will you be in when you start school in Fall 2023?
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What grade will you be in when you start school in Fall 2023?
 *
School Name:
 *
School Address (include city, state, zip):
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Parent/Guardian Name(s):
 *
Parent/Guardian Email:
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Parent/Guardian Phone Number
 *
How did you learn about the SLB? (Check all that apply.)
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Pflichtfrage
If you are a new student, why are you interested in being part of the Holocaust Center for Humanity’s Student Leadership Board? If you are a returning student, tell us about something you learned on the SLB last year, or tell us why being the on SLB is important to you.
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What extracurricular activities are you involved in?
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What skills, knowledge, perspective, or interests would you bring to the Student Leadership Board?
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Reference: List the name of one person (not a family member) that can support your qualifications for the Student Leadership Board. Please list someone who is willing to be contacted by the Holocaust Center. (OPTIONAL FOR RETURNING MEMBERS, REQUIRED FOR NEW MEMBERS)
Reference: Email address of the person you listed above.
Reference: Phone number of the person you listed above.
SLB meetings will be held twice a month on Wednesdays starting in October 2023. As of the 2023-2024 school year, all SLB meetings will be held in person at a TBD location in Southwest Washington. 

By checking "I understand", you are confirming that you will be able to make these meetings on a regular basis. Failure to consistently attend will result in dismissal from SLB. *
Are you currently living with a disability (physical, intellectual, psychiatric, visual, hearing, neurological, or other medical condition)? We are asking in order to foster an inclusive community, hold ourselves accountable, and provide accommodations as needed. Your personal information will be kept confidential. 
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If you answered "Yes" to the question above and would like to add comments, or describe any accommodations that would enhance your experience on the SLB, please use the space below.
Anything else you would like us to know?
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