Athlete Leadership University Interest Form

Thank you Thank you for expressing your interest in atending Athlete Leadership University. This form is to collect contact information and learn what Athlete Leadership University course(s) you are interested in completing.

Please note that this is NOT a registration form for Athlete Leadership University. Instead, this allows Special Olympics Pennsylvania to get the word to more athletes. In order to register, you will still need approval from your Program Manager & Regional Executive Director.

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* 1. First and Last Name

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* 2. Local Program

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* 3. Select the Athlete Leadership University Course(s) you are interested in completing.

Athlete Representative-An Athlete Representative is someone that wants to not only lead a conversation, but also is willing to take action and speak on behalf of all athletes.

Global Messenger-A Global Messenger is someone who of course enjoys to talk! It should also be someone passionate who can easily sell Special Olympics to others!

Healthy Lifestyles (training to become a Health and Fitness Coordinator)-A Health and Fitness Coordinator is an athlete committed to promoting healthier lifestyles for athletes, unified partners, coaches and families. Their primary responsibility is offering year round health and fitness clubs at least once a month to people of all ages and abilities.

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* 4. What is the best phone number to reach you at?

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* 5. What is the best email address to reach you at? (If you do not have a personal e-mail address, please give the e-mail address of your parent/guardian or another person that will share e-mail communications with you.)

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* 6. Do you have someone committed to serve as your Mentor?

Yes

Athlete Leadership University Interest Form

Question Title

* 1. First and Last Name

Question Title

* 2. Local Program

Question Title

* 3. Select the Athlete Leadership University Course(s) you are interested in completing.

Question Title

* 4. What is the best phone number to reach you at?

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* 5. What is the best email address to reach you at? (If you do not have a personal e-mail address, please give the e-mail address of your parent/guardian or another person that will share e-mail communications with you.)

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* 6. Do you have someone committed to serve as your Mentor?

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* 7. If you answered, "yes", please provide their full name, phone number, e-mail address and relation to you.