Teen Leadership Program Application

Personal Information
 
First Name:
Last Name:
Middle Initial:
Street Address:
Address (con't.)
City:
State:
Zip/Postal Code:
Home Phone:
Fax:
Email:

EDUCATIONAL INFORMATION

Name of High School:
Graduating Class:
Grade Point Average:
Participation in sports:
Participation in Clubs, Societies or Other:

CIVIC INFORMATION

Involvement in Civic Organizations:
Positions Held:
Other Community Related Activities:

Please answer the following questions. Please keep answers to no more than what would fit on one page of notebook paper or less.

1. Please explain your interest in the Teen Leadership program.

2. In your opinion, what problems pose a significant threat to Osceola County?

3. How do you envision making use of your talents and abilities to address the problems you see as prevalent to Osceola County?

Please have a faculty member or community leader complete the following information (not a family member):
Recommended by:
Contact Phone #:
Why do you feel this student would be an asset to the Osceola Teen Leadership Program?

 
 
 
 
 
   
Community Vision, Inc. 704 Generation Point, #101, Kissimmee, FL 34744
Ph: 407-933-0870    Fax: 407-933-0942