The application must be completed by March 7, 2019. The Selection Committee will review only completed applications submitted by the deadline. There is no fee to apply. If selected, the program fee of $100 will be covered by scholarship. All applicants will be notified of selection in May 2019.

You must be a current high school sophomore residing in Pottawattamie County to apply for this program. Participation in the Youth Leadership Council Bluffs program occurs during your high school junior year.

Question Title

* 1. Youth Leadership Applicant Information:

Question Title

* 2. School Related Activities: List up to five school related activities in which you have participated during the last two years.

Question Title

* 3. If you haven’t had the opportunity to participate in school activities/organizations, why not? (Check all that apply.)

Question Title

* 4. Non-School/Non-Work Activities: List up to five non-school related or non-employment related activities in which you have participated during the last two years. (For example: community, civic, religious, scouting, volunteer, athletics, etc.).

Question Title

* 5. If you haven’t had the opportunity to participate in non-school activities/organizations, why not?

Question Title

* 6. List any special recognition or honors for academic, religious, sports, or community related activities have received or the last two years. If you have not received any recognition or honors, please indicate by "N/A".

Question Title

* 7. If selected for the Youth Leadership Council Bluffs program, how would you balance your extracurricular activities with your commitment to the program?

Question Title

* 8. Will you be employed during your Junior school year?

Question Title

* 9. What career(s) do you have an interest in?  What about them interests you?

Question Title

* 10. If you could spend a day with a current world leader, artist, or sports star, who would you choose and why?

Question Title

* 11. Describe a special gift or talent you have and how do you utilize your talent to benefit others.

Question Title

* 12. How can you be a role model for younger children in your community?

Question Title

* 13. Describe a time when your actions positively affected a person, your school, or your neighborhood.

Question Title

* 14. If you could change anything about your school, what would it be and why?

Question Title

* 15. If you could change anything about your community, what would it be and why?

Question Title

* 16. What is the likelihood that you will reside in Council Bluffs area after high school, college, etc.?

  Not Likely Somewhat Likely Very Likely Not Sure
Rank:

Question Title

* 17. How did you find out about Youth Leadership Council Bluffs?

Question Title

* 18. What else would you like to tell us about yourself?

Question Title

* 19. Please provide two adults references. Someone who knows you well, excluding parent, guardian, or relative (example: teacher, employer, faith leader, etc.).

Question Title

* 20. Parent(s)/Legal Guardian

Question Title

* 21. School Principal

T