Youth Action 2020-2021 Service Leader Program Application
Youth Action’s Service Leader Program (SLP) works with upperclass high school students who are alumni of the Junior Youth Action (JYA) and Inspiring Leaders (ILP) programs and provides students with volunteer opportunities as well as advanced leadership workshops around socially responsible leadership in college & career.

The SLP Program meets twice a month from September through May at the University of the Sciences from 10am - 1:30pm.

If you are interested, please complete the application below. If you have any additional questions, please contact inspire@youthactionteam.org or call 1-888-YOUTH90 ext 906.

**Application Deadline: Friday, July 24, 2020**
Applicant Information
Please fill in the following fields with the Student Applicant's information.
First Name *
Your answer
Last Name *
Your answer
Address *
Street Address, City, State, & Zip Code
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Phone Number *
Please enter using this format: (XXX) XXX-XXXX
Your answer
Email Address *
Please verify that your email address is typed correctly.
Your answer
School *
Your answer
Grade Level for Fall *
Your Passion/Career Interest *
Your answer
Parent/Guardian Information
Please fill in the following fields with Parent/Guardian information.
Parent/Guardian First Name *
Your answer
Parent/Guardian Last Name *
Your answer
Parent/Guardian Email Address *
Please verify that the email address is typed correctly.
Your answer
Parent/Guardian Phone Number *
Please enter using this format: (XXX) XXX-XXXX
Your answer
Relationship to Student *
Your answer
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