Regional Leadership Council (RLC) Application 2022/2023
This application is for all high school students interested in one of Operation Smile Student Programs various U.S. Regional Leadership Councils for the 2022-2023 school year.

Applications are due, April 29, 2022.

If you have any questions about the application process or the roles and responsibilities, please contact your Regional Associate:

VIRGINIA, HAMPTON ROADS, WESTERN U.S. - Pete Hansen: pete.hansen@operationsmile.org
NORTHERN U.S. - Morgan Banaszek: morgan.banaszek@operationsmile.org
SOUTHERN U.S. - Jackie Nguyen: jacqueline.nguyen@operationsmile.org

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Email *
Select Application Region *
First Name *
Last Name *
Date of Birth (MM/DD/YYYY) *
Email Address *
Cell Phone Number *
City *
State *
School Name *
Graduation Year *
Role in your school's Operation Smile Club. (Do you anticipate being an officer in your club next year?) *
Are you re-applying for an another year as a RLC member? *
Are you interested in the Recording Secretary role? Please read the Roles and Responsibilities document for what skills this role requires. *
T-Shirt Size *
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