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* 1. Fellow name:

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* 2. Date of birth:

Date

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* 3. Gender:

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* 4. Preferred Pronouns

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* 5. Current grade:

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* 6. School name

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* 7. How did you hear about this experience?

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* 8. Which week best aligns with your schedule?

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* 9. Are you required to complete community service hours for school? If so, how many per year?

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* 10. Please list any injuries, accessibility needs or physical limitations we should be aware of (e.g., lifting, mobility, or building access)?

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* 11. Parent/Guardian 1 name:

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* 12. Parent/Guardian 2 name:

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* 14. Student's phone number:

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* 15. Address:

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* 16. Why are you interested in this leadership experience?

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* 17. What’s a topic/cause you care deeply about?

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* 18. Have you ever volunteered, mentored, or helped in your community? If yes, tell us a little about it.

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* 19. What strengths would you bring to a team of student ambassadors?

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* 20. This program is about growing as a leader. What’s one way you’d like to grow this year?

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* 21. Please list any scheduling conflicts that might interfere with your ability to participate in the full programming schedule.

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