iLEAD/VOICE Application!

 iLEAD/VOICE is Indiana's statewide youth advocacy brand! Through joining iLEAD/VOICE teens will gain effective communication skills, time management skills, and leadership experience from this opportunity. Skills learned through iLEAD/VOICE will help youth learn the importance of goal setting at the next stage in their careers!

VOICE is a state-wide initiative that encourages peer-to-peer youth movements, dedicated to exposing the tobacco industry and preventing tobacco/nicotine usage among teens. Our mission is to engage, educate, and empower young people as leaders and advocates within their communities through youth-adult partnerships, positive development, and public health advocacy training.

iLEAD/VOICE is looking for core and action squad members to represent Vigo County on the local and state level. If you are a teen between the ages of 12-18 and are interested in gaining advocacy, leadership, teamwork, and communication skills consider applying for iLEAD/VOICE now!

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Name *
School *
Date of Birth *
Age *
Phone Number  *
E-Mail *
Grade *
Home Mailing Address *

Please list any medical conditions or special needs you may have

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Please specify any food allergies and/​or special medication that our staff should be aware of when you are in our space and participating in iLEAD/VOICE programming
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Why are you interested in joining iLEAD/VOICE as a core/action squad leadership member?
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What would you say are your top 3 strengths (skills, attributes, characteristics, talents, etc.?) Examples include: Social media savvy, creative, great communication skills, team oriented, hardworking, patient, etc.
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Tell us about your extra - curriculars, family and interests and how these areas could enhance your leadership capabilities? 


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PARENT CONSENT


I give my youth  _________________________________ , permission to apply for the  iLEAD/VOICE program. I understand this program will require commitment and additional responsibilities for both my child and myself. 


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Parent/Guardian Name *
Parent/Guardian Phone Number *
Parent/Guardian E-mail  *
Emergency Contact Name  *
Emergency Contact Phone *
Emergency Contact E-Mail *

Photo and Media Release

Your child/youth may be photographed, audio recorded or videotaped for the purposes of promoting and publicizing iLEAD/VOICE. By allowing your child to be photographed, you waive all rights to the photographs, audio, and video tapes in which your child appears. The photograph, audio, or video tape may only be used whole, in part, or in composite as the program sees fit in publication of education material, the advertising thereof, for any other lawful purpose. Please type your name and your child's name below:


I, _______________________________ (parent or guardian)


Give my child  _____________________________(iLEAD/VOICE Member) 


permission to be photographed, audio record, or videotaped for future promotions or informational packages put together by the CASY staff . 


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