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The Resilient Youth Program
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Youth Leadership Council Form
Youth Full Name
Email Address
Age
Why do you want to be part of the youth leadership council? (select all that apply)
*
Required
To build up my resume
For the leadership opportunities
To increase scholarship opportunities
To gain some valuable skills
To make friends
To help & lift others
To serve in my community
Other
Legal Guardian Full Name
Legal Guardian Email Address
How did you hear about us at Rising Up Together?
*
Required
Social Media
Radio Ad
Newsletters
From a friend, neighbor, or family member
Signs or flyers
Other
What days are you able to meet?
*
Required
Monday
Tuesday
Wednesday
Thursday
Friday
Answer the following questions: 1.What do you want to do in youth council? 2. What do you want out of this experience? 3. What do you want to be able to talk aboout?
How many days a week would you like to met?
*
Required
Once A Week
Twice A Week
Three Times A Week
I would want to meet once a week as a council and have an additonal bonding meeting
Answer the following questions: 1.What do you want to do in youth council? 2. What do you want out of this experience? 3. What do you want to be able to talk aboout?
Please have a parent or gurdian read the following waiver then sign! -->
Clear
Submit
Thank you! We will connect with you soon!
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