Youth Leadership Challenge Application

Youth Leadership Challenge Application

First Name*

Last Name*

Gender*

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Birth Date*

High School*

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Mailing Address*

City*

State*

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Zip*

Phone*

Phone

Email Address*

Shirt Size*

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Parent/Guardian First Name*

Parent/Guardian Last Name*

Parent/Guardian Address*

Parent/Guardian City*

Parent/Guardian State*

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Parent/Guardian Zip*

Parent/Guardian Email*

Parent/Guardian Phone*

Phone

MLEA Account Number*

Tell us about yourself*

Please tell us briefly about your life, including your interests and hobbies. Also, please include any honors received or offices held.

College/Career Goals*

Please outline your college and career goals, and plans to achieve them.

Community Involvement*

List any community involvement, including school or local clubs.

Why You*

Please tell us how you heard about the Michael F. Peterson Youth Leadership Challenge, and why you would like to participate.

Document Upload*

Please upload the following documents:

Drag and drop files here or

Send me a copy of my responses