Junior Leadership Application

Junior Leadership Salina 2018 Application Form

A Program of the Salina Area Chamber of Commerce

* Indicates required field

Name *

First

Last

Age *

Gender: *

Male Female

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

School *

Email *

Parents/Guardians *

List the extracurricular activities you are involved in at your school, church and community.

Organization *

Leadership Position(s) *

EMPLOYMENT (if applicable)

Present Employer *

Date Began *

Present Title or Responsibility *

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 and 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 my intention 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.

Submit