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Junior Leadership Salina Application Form

Click here to download and print the Junior Leadership Salina Application.

Please complete the following information:

Name (Last, First, Middle)
Age	Male Female
Home Address
City/State
Zip
School
Area Code/Phone
Email
Parent (s)
List the extracurricular activities you are involved in at your school, church, and community.
Organization	Leadership position (s)









Present Employment
Present Title or Responsibility
Date Began
Hours of work per week
The goal of Junior Leadership Salina is to provide information and education about the diversity of this community, its challenges, its resources, its concerns. What do you expect to gain from this program?
How do you see yourself using Junior Leadership Salina training to expand your future involvement in the community?
What are your future vocational plans?
How did you learn of this program?
Who recommended this program to you?

Tuition for the program is $100.00. Each participant will be responsible for paying $25. The remaining $75 will be underwritten by the Salina Business Community and other interested persons.

I am completely aware of the time required for Junior Leadership Salina and I pledge to attend each of these sessions. I understand that I must attend all of the events to graduate.

I also understand that two letters of recommendation are required with this application supporting my nomination and leadership potential. One of the letters must be written by someone other than a teacher or school administrator.

I am aware of the commitment required by Junior Leadership Salina and will allow my son/daughter to participate.

Submission of this form permits applicant's signature and parent's signature to the above statements.

APPLICATION DEADLINE: January 16, 2008

For more information about Junior Leadership Salina please contact: Don Weiser