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APPLICATION
Name _______________________________________________ Date
of Birth ________________
Home Address ___________________________________________________________________
City ________________________ State ________ Zip ___________
County _________________
Home Telephone (____)____________________ Fax (_____)_____________________________
Home E-mail _____________________________________________________________________
High School You'll Attend in September 2003___________________________________________
High School Address _______________________________________________________________
City ___________________ State _________ Zip ______________
County ___________________
School Telephone (____)___________________
Grade by September 2003 ____ Sophomore ____ Junior
Briefly answer the following questions on separate paper.
All answers should be typed.
Questions 1 - 3 should be no longer than 1 page TOTAL in length.
1. Why do you want to be a part of Volunteer Jacksonville's
Prudential Youth Leadership Institute?
2. Who most exemplifies leadership to you (living or deceased)?
Why?
3. After the summer program ends, how will you use your leadership
skills to recruit and involve other young people in community
service?
4. Please provide a short biography (no more than 100 words)
including your involvement in the community, extra curricular
activities, and personal interests.
Please provide one letter of recommendation from a teacher,
employer, religious leader, or someone outside of your immediate
family who knows you well.
Please return completed application packets to Volunteer
Jacksonville
no later than Friday, April 18, 2003.
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