Youth Leadership Henry Class of 2026 Application

1.

Student Information *

Student Name: First and Last:

Name you Prefer to be Called:

School Attending:

Home Address:

City/Town:

State:

Zip Code:

Student Email Address: (Cannot use school email "@henry.k12.ga.us")

Student Cell Phone Number:

Student Age:

Student Gender:

Student Shirt Size:

Parent/Guardian #1 Name:

P/G #1 Email Address:

P/G #1 Cell Phone Number:

Parent/Guardian #2 Name:

P/G #2 Email Address:

P/G #2 Cell Phone Number:

2.

If accepted into the class and upon completion of the program, how would you like for your name to appear on the graduation certificate? *

3.

List below five ACHIEVEMENTS (including, but not limited to: honors, recognitions, awards) that you have accomplished from the 7th grade through the present. Include academic, school, or community-related activities. *

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4.

List below up to five volunteer activities or organizations in which you have participated during the last four years, giving of your time and/or resources to help others. *

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5.

Identify any part-time job experience or volunteer experience you have. Would your job or volunteer position interfere with your commitment to the program if you are accepted? *

6.

What goals (personal, educational, and/or career goals) have you set for your future, and how do you plan to attain those goals? *

7.

What do you think are the three most pressing issues facing our community? *

8.

As a leader in the community, what changes would you make and why? *

9.

What do you hope to gain by participating in Youth Leadership Henry? *

10.

What makes you the best candidate to select for our program this year? *

11.

DUE AUGUST 22nd, 2025 BY 4PM: By checking this box, I understand that I am required to obtain one letter of recommendation from a non-family member who believes I would benefit from this program and submit it in person at the Henry County Chamber of Commerce OR will scan and email it to info@youthleadershiphenry.com no later than the application deadline listed on the website (www.youthleadershiphenry.com). (A full application checklist can be found on the YLH Class of 2026 Info Sheet located on the website.) *

Yes, I understand

12.

DUE AUGUST 22nd, 2025 by 4PM: By checking this box, I understand that I am required to submit the fully completed Signature Commitment Sheet located on the website (www.youthleadershiphenry.com) in person at the Henry County Chamber of Commerce OR will scan and email it to info@youthleadershiphenry.com no later than the application deadline listed on the website. (A full application checklist can be found on the YLH Class of 2026 Info Sheet located on the website.) *

Yes, I understand