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* 1. What is your FIRST name?

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* 2. What is your LAST name?

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* 3. How old are you?

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* 4. What is your HOME address?

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* 5. What is your ZIP code?

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* 6. What is your email address? (this email will be used for communication purposes during the duration of the program)

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* 7. What is your cellphone number? (this number will be used for communication purposes during the duration of program)

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* 8. Please provide the NAME and PHONE NUMBER of your PARENT and or GUARDIAN.

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* 9. Please provide a PARENT/GAURDIAN email address.

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* 10. Please provide NAME and PHONE NUMBER of the person we should call in the case of an EMERGENCY.

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* 11. What is your relationship with this person?

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* 12. What grade are you in?

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* 13. What school do you attend?

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* 14. How did you hear about the National Youth Congress Program?

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* 15. If selected, which session would you like to be considered for?

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* 16. Please share why you should be chosen to participate in National Youth Congress. (at least 150 words)

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* 17. If selected, what do you hope to gain from the National Youth Congress experience? (at least 150 words)

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* 18. Please describe your past and present volunteering experiences, community and/or religious involvement. Include name of organization(s), position(s) you have held, your responsibilities, duration of the position, and the name of your immediate supervisor (s).

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* 19. If selected, what would you bring to the National Youth Congress program?

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