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Student Leadership Application
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Indicates required field
Name:
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First
Last
Preferred Pronouns:
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Address:
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Home Phone #:
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Cell Phone #:
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Grade in School:
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School:
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Birthday:
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School ID #:
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Email Address:
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Who recommended you to the program?
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What is the best way to contact you?
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Email
Text
Home Phone
Meetings are twice a month, can you commit to attending all of the meetings?
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Yes
No
Are you willing to commit to participating in Community Involvement/Volunteer events at least once a semester as a Student Leadership member?
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Yes
No
Are you willing to participate at events (meetings, networking events, projects, events, etc.) as a representative of Kramerica Gives Student Leadership Program?
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Yes
No
Do you currently volunteer in your community?
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Yes
No
Would you be able to get to and from the Leadership meetings that are held at a central location?
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Yes
No
What has been a valuable experience for you in your life?
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What are your plans for your future? What motivates you?
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Who do you view to be a leader in your community? Why?
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What has been the biggest challenge you have had to overcome while in high school?
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What are you most proud of or what is something really important to you?
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Student Signature: (Please type in your full name and this will serve as your signature)
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Signature Date:
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Parent Signature: (Please type in your full name and this will serve as your signature)
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Signature Date:
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Submit
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Events
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