Teens Leading North County Application

North County Lifeline

Thank you for your interest in the winter session of Teens Leading North County! This program offers service leadership to local high school students while they learn about local gardening in North County. It will take place January 6th through January 9th, from 1 pm-4 pm, in Oceanside. To participate in Teens Leading North County, please complete the following application. If you have any questions or concerns, please feel free to call (760) 842-6254 or email volunteer@nclifeline.org. This program is open to all high school students.

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* 1. Name. First and Last name.

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* 2. Contact Information

Phone Number:

Email Address:

Mailing Address:

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* 3. Emergency Contact. Full name and cellphone number.

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* 4. Do you have health insurance? Note: Volunteers have limited coverage under Lifeline's Worker's Compensation Insurance.

Yes

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* 5. Have you been a Lifeline client before?

Yes

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* 6. High school graduation year?

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* 7. Birthday

Date / Time

Date

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* 8. Please list any past volunteer experience/extra -curricular activities. This can be related to school, church, sports, or any other activities.

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* 9. What interests you about Teens Leading North County?

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* 10. Are you interested in being a Teen Lead for the program?

Yes, I am interested in devoting more time to the program and serving as a leader to my peers.

No, I am not interested in becoming a Teen Lead.