Youth Action 2019-2020 Service Leader  Program Application
Youth Action’s Service Leader Program (SLP) is for exceptional 10th-12th grade students with leadership and service experience who want to further develop their leadership skills while engaging in community service to gain service hours. This program provides students with volunteer opportunities as well as advanced leadership workshops around socially responsible leadership in college & career.  Alumni of the Junior Youth Action (JYA) and Inspiring Leaders (ILP) programs are also urged to apply.

The SLP Program meets twice per month during September through May from 10 AM - 1:30 PM.

If you are interested, please complete the application below. If you have any additional questions, please contact inspire@youthactionteam.org or call 1-888-youth90 ext 906.

**Priority Application Deadline: Friday, September 13th, 2019 at 11:59 PM**
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Applicant Information
Please fill in the following fields with the Student Applicant's information.
First Name *
Last Name *
Address *
Street Address, City, State, & Zip Code
Date of Birth *
MM
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DD
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YYYY
Phone Number *
Please enter using this format: (XXX) XXX-XXXX
Email Address *
Please verify that your email address is typed correctly.
School *
Grade Level for Fall *
Discuss what leadership skills and qualities you possess that will make you an effective member of the Service Leader Program and what you hope to gain from the Program. *
What is your passion/career interest? *
Parent/Guardian Information
Please fill in the following fields with Parent/Guardian information.
Parent/Guardian First Name *
Parent/Guardian Last Name *
Parent/Guardian Email Address *
Please verify that the email address is typed correctly.
Parent/Guardian Phone Number *
Please enter using this format: (XXX) XXX-XXXX
Relationship to Student *
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