LOT 2019 Student Application
2019 - 2020 Leaders of Tomorrow Atlanta Chapter Application
Email address *
Last Name: *
Your answer
First Name: *
Your answer
Date of Birth: *
MM
/
DD
/
YYYY
Email Address: *
Your answer
Cell Number: *
Your answer
Is it okay to text you on Cell Number *
Yes
NO
Row 1
Home Phone:
Your answer
Home Address: *
Your answer
City *
Your answer
State *
Your answer
Zip Code: *
Your answer
Parent or Guardian's First and Last Name *
Your answer
Relationship of Student of to Parent or Guardian *
Your answer
Parent or Guardian Email address: *
Your answer
Parent or Guardian Cell Number: *
Your answer
Student Emergency Contact Name *
Your answer
Student Emergency Contact Phone Number: *
Your answer
Emergency Contact Relationship to Student: *
Your answer
Please list any allergies or medical conditions or write "N/A" if none *
Your answer
Name of High School: *
Your answer
High School Street Address: *
Your answer
High School City: *
Your answer
High School State: *
Your answer
High School Zip Code: *
Your answer
Current High School Grade *
Your answer
G.P.A (May/June 2019): *
Your answer
HONORS/AP/IB CLASSES: *
Your answer
AWARDS: *
Your answer
FAVORITE SUBJECTS: *
Your answer
SUBJECT(S) IN WHICH YOU STRUGGLE: *
Your answer
EXTRA CURRICULAR ACTIVITIES *
List Activity, Position Held and Grade Participated
Your answer
LIST ANY COMMUNITY SERVICE/VOLUNTEER PROJECTS: *
Your answer
LIST COLLEGES/UNIVERSITIES YOU ARE INTERESTED IN APPLYING TO: *
Your answer
LIST YOUR CAREER GOALS AND/OR COLLEGE MAJOR: *
Your answer
HOW DO YOU PLAN TO PAY FOR COLLEGE? : *
Your answer
LIST COLLEGE SCHOLARSHIPS APPLIED TO AND/OR RECEIVED AND THEIR VALUE.: *
Your answer
WHY DO YOU WANT TO JOIN THE LEADERS OF TOMORROW? *
Your answer
HOW HAVE YOU OR HOW WILL YOU DEMONSTRATE LEADERSHIP IN LOT OR WITHIN YOUR SCHOOL OR COMMUNITY? *
Your answer
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