Youth Action 2019-2020 Service Leader Program Application
Youth Action’s Service Leader Program (SLP) is for exceptional 10th-12th grade students with leadership and service experience who want to further develop their leadership skills while engaging in community service to gain service hours. This program provides students with volunteer opportunities as well as advanced leadership workshops around socially responsible leadership in college & career. Alumni of the Junior Youth Action (JYA) and Inspiring Leaders (ILP) programs are also urged to apply.

The SLP Program meets twice per month during September through May from 10 AM - 1:30 PM.

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.

**Priority Application Deadline: Friday, April 20, 2019 at 11:59 PM**

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 *
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DD
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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 *
Discuss what leadership skills and qualities you possess that will make you an effective member of the Service Leader Program and what you hope to gain from the Program. *
Your answer
What is 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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