Melissa High School PALS Student Application
The Peer Assistance and Leadership® (PAL) program focuses on working with elementary, middle, and high school age youth. Participants receive effective training in resiliency strategies. Course content and interactive activities combat issues like school violence, drug use/abuse, teen pregnancy, gang participation, school dropouts, and/or behavior problems.

In order to be considered for the PAL program, you must:
  • Complete and submit this application form
  • Download the PAL Teacher Recommendation Form and ask a teacher to complete the form on your behalf.
Applications will not be considered complete until the Teacher Recommendation form has been received.
Sign in to Google to save your progress. Learn more
First and Last Name *
Student ID *
Student Email Address *
Date of Birth *
Choose One: *
Grade Level for the 2023-2024 School Year? *
Please read the following statements and type your full name in the box below indicating your agreement and understanding . *
  1. I understand that if I am a PAL I will have to, and will be willing to, work with special needs students. 

  2. I understand that if I am a PAL I will occasionally have to, and will be willing to, participate in community service related activities (i.e. attending Trunk or Treat, Dinosaur Night at HME, Daddy Daughter Dance, Concessions Stands, etc.)  

  3. I understand that if I am a PAL I will be looked upon as a role model by my peers, by my community, and by youth, and I will pledge as such.

Clear form
Never submit passwords through Google Forms.
This form was created inside of Melissa Independent School District. Report Abuse