Athlete and Youth Leadership creates opportunities for Special Olympics athletes and youth to develop and demonstrate leadership skills, utilize their voices and abilities to undertake meaningful leadership roles, and influence change inside and outside Special Olympics.

You have been asked to complete this profile because you are an Athlete or Youth Leader. You must be at least 12 years of age (no upper age limit) and currently in a leadership role of some capacity whether it be a Global Messenger, coach, fundraiser, Special Olympics employee, board member, committee or some other leadership role. If you are participating in a leadership role as a Unified pair, both the athlete and partner should complete their own individual forms, but note their partner’s name in the space provided. 

This profile will take approximately 15-20 minutes to complete. You must complete all the questions at one time and cannot save and go back. You will be given the option at the end of the survey to include a video link of yourself and upload a digital photo. This will help to create a more complete profile of yourself as an Athlete or Youth Leader.

Thank you making a difference by serving as an Athlete or Youth Leader.

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* 1. First name:

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* 2. Last name:

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* 3. Email:

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* 4. Mobile phone number (with area code):

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* 5. Home phone number (with area code):

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* 6. What is your address:

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* 7. Gender: 

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* 8. What is your date of birth?

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* 9. What is your race/ethnicity? (optional) 

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* 10. Special Olympics Accredited Program (i.e.; "Special Olympics Indiana")

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* 11. What is your role within Special Olympics?

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* 12. Number of years involved with Special Olympics

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* 13. Do you use email regularly? (at least 5 times per week) 

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* 14. Do you use text messaging?

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* 15. If using social media, you may provide your user name or handle here (not required):

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* 16. Are you currently a student?

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* 17. Level of Education Completed:

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* 18. Are you employed? 

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* 19. If yes, what is your employment status?

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* 20. If employed, please share a few more details...

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* 21. Have you completed any formal Special Olympics Leadership trainings? (please check all that apply)

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* 22. What experiences have you had in Special Olympics or in your community? (check all that apply)

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* 23. STRENGTHS:  Rate yourself 1 – 5 in each area with 5 being the strongest and 1 the weakest.

  1 2 3 4 5
Public Speaker
Committee Member
Social Media
Working as a peer mentor (helping others)
Fundraiser

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* 24. AREAS OF STRONG INTEREST: Rate your interest in these areas with 5 being the strongest and 1 the weakest.

  1 2 3 4 5
Sports & sports rules
Coaching
Health & fitness
Social Media & public awareness
Fundraising & sponsorships
Games & event management
Public speaking & advocacy 
Input councils or committees

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* 25. List any Special Olympics competitions or conferences you've attended beyond the state level in the last 5 years (regional, national, and international events):

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* 26. Are you able to travel independently without a mentor?

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* 27. If no, please list what support you need when flying or traveling:

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* 28. Please describe any physical accessibility needs you have (i.e. wheelchair, walkers, assistive devices)

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* 29. Do you have a speech coach or mentor that works with you on a consistent basis to help you improve your skills as a leader?

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* 30. If you have a mentor, please list that person's name, email and phone number:

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* 31. Do you do leadership activities as a Unified pair with anyone? If yes, please list that person’s name and the types of activities you do together.

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* 32. Please list all Special Olympics sports in which you participate:

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* 33. What is your favorite sport and why?

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* 34. If someone was going to describe you with one word what would it be: 

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* 35. Video or Web Links (optional): Please copy/paste any videos or youtube links that show your leadership skills in action (i.e. public speaking).

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* 36. Photo upload (optional): Please use this space to upload a photo of yourself.  Ideally, this would be a professional photo or a head shot similar to what would be on a photo ID.  

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Special Olympics is committed to expanding its outreach and impact on our athletes, their families and their communities.

To do this we must have leaders with vision, the skills and the tools to build and grow Special Olympics Programs that change more and more lives and communities; and among those leaders, there must be an increasing number of athletes and youth who contribute their unique skills, perspectives and talents.

Thank you for completing this Athlete & Youth Leader Profile.

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