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Teen Leadership & Service Academy Application
Please complete this application to be considered as a student leader candidate with Continuing Education's Teen Leadership & Service Academy.
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* Indicates required question
Name
*
Your answer
Email
*
Your answer
Phone Number
*
Your answer
Current Age
*
Your answer
Current GPA
Your answer
What grade level will you be entering in fall of 2021?
*
9th Grade
10th Grade
11th Grade
12th Grade
What clubs or service organizations do you participate in, either at school or in the community?
Your answer
What does your past experience at Heartland Community College look like?
*
Kids@Heartland or Youth Enrichment Program (YEP) participant
Challenger Learning Center participant
Child Development Lab participant
College Now/Dual-Credit student
No previous affiliation
Other:
Required
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