2014-2015 RYL Application

RICHARDSON YOUTH LEADERSHIP APPLICATION FORM

2016 – 2017

PERSONAL INFORMATION

Last Name: / First Name: / Nickname:
Male Female / Birthdate:
(mm/dd/yy) / School:
Student Email:
Home Phone: / Student Cellphone:
Mailing Address: / City: / Zip
Father’s Name: / Mother’s Name:
Father’s Email: / Mother’s Email:
Father’s Cellphone: / Mother’s Cellphone:

ORGANIZATIONS AND ACTIVITIES

Please list in order of importance to you up to five school, volunteer, religious, athletic or other organizations in which you have participated from the 7th through the 10th grades. In the “RYL Year?” column, enter Yes or No on whether you plan to participate next year while in RYL.

Organization/Activity / Grades in School / RYL Year / Leadership Responsibility/Involvement

SCHOOL EXPERIENCE

List up to three special awards, honors, or recognitions for academic, school or community-related activities you have received from the 7th through 10th grades:

WORK EXPERIENCE

List any part-time job experience – paid or volunteer – and describe.

Do you currently have a part-time job? Yes No / How many hours per week?
Will your job interfere with participation in RYL? Yes No
Will your extracurricular activities interfere with participation in RYL? Yes No
If yes, please explain.

GENERAL INFORMATION

What are your educational and career goals?

What skills do you hope to gain from participating in RYL?

Which well-known historical or public figure do you most admire, and why?

List five traits that a leader possesses.

REFERENCES/ TRANSCRIPT

Please provide a letter of recommendationfrom an employer or another person in the community who is not related to you.Include a copy of your last report card and transcript.

ATTENDANCE

By signing below, you agree to make a commitment to attend the orientation, each of the six programs, and the graduation ceremony.

Signature of Applicant ______Date ______

Signature of Parent/Guardian ______Date ______

Applications must be postmarked no later than March 31, 2015. Mail application to:

Leadership Richardson Alumni Association

PO Box 830322, Richardson, TX 75083