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Jefferson Community Youth Leadership Class of 2027 Application
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1.
First Name
(Required.)
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2.
Last name
(Required.)
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3.
School
(Required.)
4.
Grade level in the fall?
Junior
Senior
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5.
Home Street
(Required.)
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6.
City
(Required.)
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7.
State
(Required.)
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8.
Zip Code
(Required.)
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9.
Mobile Phone
(Required.)
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10.
Email address
(Required.)
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11.
What programs are you involved with at your school?
(Required.)
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12.
What qualities should a leader have?
(Required.)
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13.
What are your hopes for the future of Jefferson Parish?
(Required.)
14.
Are you able to attend the mandatory Opening Retreat on Saturday, September 26?
Yes
No
15.
Class Sessions are scheduled on the following school days from 8:30 a.m. - 3:00 p.m.:
Wednesday, October 21, 2026 Healthcare Session
Wednesday, November 18, 2026 Education Session
Wednesday, December 16, 2026 Economic Development Session
Wednesday, January 20, 2027 Law Enforcement/Governance Session
Wednesday, February 17, 2027 Community Involvement Session
Wednesday, March 17, 2027 The Story of You, The Story of Us
Wednesday, April 14, 2027 Graduation Dinner from 6-8pm
Do you have permission from your school administration to attend?
Yes
No
16.
Do you have any food allergies? And if so, what are they?
17.
Do you have your parent/guardian's permission to participate in the program?
Yes
No
18.
Photo & Media Release
If accepted into the program, my parent/guardian grants permission to the Jefferson Community Foundation to photograph, video record, and/or use images of me participating in the Jefferson Community Youth Leadership (JCYL) program for promotional, educational, and communication purposes.
I understand these images may be used in print materials, social media, websites, presentations, and other communications related to the program and the work of the Jefferson Community Foundation.
I understand that no compensation will be provided for the use of these images.
Yes
No
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