Youth Forward 2019 Application
Do you want to:
-Develop your leadership potential?
-Meet local leaders of ALL ages?
-Connect more deeply with your community?

You're in the right place! Formerly Junior Leadership Southside, Youth Forward is a leadership program designed to help YOU maximize your abilities, right where you live!

Youth Forward is facilitated by Middle Border Forward. It will meet in Danville, Virginia 9:00am-4:00pm, Monday-Wednesday, June 10-12 and June 17-19, 2019. There is no cost to attend. All participants will receive a $300 stipend upon completion of program. Lunch will be provided daily.

Applications are due April 15, 2019 by 11:59pm. If you have any questions, please do not hesitate to contact, or call (434) 483-2894.

Email address *
First & last name *
Home address *
Main phone number *
What best describes your gender? *
Race/Ethnicity (Providing your race/ethnicity is voluntary. No selections are made based on this information.)
High school name *
Grade *
T-shirt size *
Parent/Guardian first & last name *
Parent/Guardian address *
Parent/Guardian main phone *
Parent/Guardian email *
Letter of Recommendation *
Please provide the email address of an adult (not a parent/guardian or other relative) who can tell us more about your skills and leadership potential. We will contact them directly.
Tell us about yourself!
We want to know what makes YOU unique. Write as much as you want, but at least 3 sentences per question!
What's something no one would guess about you? *
What do you do outside of school? (Ex: work, sports, yoga, play music, etc.) *
If you could be doing anything, anywhere right now, what would it be? *
What is something you had to overcome in your life and how did you do it? *
If your friends had to describe you, what would they say? (Ex: a good listener, the one who makes the decisions, the one always making jokes, etc.) *
Do you rap? Draw? Dance? Have more to say that can't fit into the questions above? Upload a file to show us more about who you are, what you do, or what you love. You can also text or email the file: (434) 879-6786 or
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