CDYMCA Outstanding Student Application - SSY
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Applicant Information
First Name *
Last Name *
Street Address *
Email Address *
City & Zip Code *
Grade *
School District *
School Name *
Gender *
Phone
YMCA Member? *
Please feel free to attach a resume outlining your accomplishments and community involvement.
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Resume
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Parent/Guardian Information
First Name *
Last Name *
Home Address (if different from above)
Daytime Phone *
Sponsor Information
Have an adult who can verify your community service activities and will serve as a "sponsor". Have your sponsor complete the LETTER OF RECOMMENDATION FORM by clicking the link on the website. This person may be contacted to answer questions regarding your service activities. You are welcome to identify a secondary sponsor. Parents/ guardians should not be your sponsor(s)!

First Name of Primary Sponsor *
Last Name of Primary Sponsor *
Relationship with Applicant *
Daytime Phone *
Email Address *
First Name of Secondary Sponsor (optional)
Last Name of Secondary Sponsor
Relationship with Applicant
Daytime Phone
Activity Summary
Describe a few school, community, and/or YMCA service activities. Be sure to include what you did, what leadership positions you held (if any), how long you have been involved, how much time you spend on the activities, and who else is involved (e.g.,family, friends, groups). *
Results
Describe the impact of your efforts. Be sure to include who benefited from your work, if the activity will continue in the future, and whether the results meet, exceeded, or fell short of your expectations *
Reflection
Describe how you personally were affected by your activity. State what you may have learned from the experience, what skills were acquired, and what you would tell other people about your experience. *
Biography
Provide a 100-150 word biography highlighting the above to be used for the event program. *
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