To The Reference Provider:

This applicant is interested in Youth Leadership Long Beach, a seven-month leadership development program for high school youth who live or go to school in Long Beach. This year's program will have a focus on environmental sustainability and run from October 2018 until April 2019. Please visit our web site at www.leadershiplb.org to learn more about Leadership Long Beach and our programs.

Youth Leadership Long Beach brings together participants who are diverse in many ways, including their amount and type of leadership experience. We are not looking only for young people with significant achievements, but also those with lots of potential. Your comments give us a key perspective that we take very seriously in our selection process. Please give your honest opinion of this applicant in response to the following questions.

If you have any questions, please contact Jeff Williams, Executive Director, at (562) 997-9194 or e-mail youthllb@leadershiplb.org Your responses will be kept confidential. Thank you!

The deadline for reference submission is June 30th, 2018.

Your Title

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* 1. Your Title

Your Name

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* 2. Your Name

School or Organization

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* 3. School or Organization

Your Address

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* 4. Your Address

City, State, and Zipcode

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* 5. City, State, and Zipcode

Work Phone

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* 6. Work Phone

Work E-mail

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* 7. Work E-mail

Student Applicant's Name

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* 8. Student Applicant's Name

Student Applicant's High School

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* 9. Student Applicant's High School

To be eligible for Youth Leadership Long Beach, the applicant must live or go to school in Long Beach and be a high school Sophomore (class of 2021), Junior (class of 2020), or Senior (class of 2019) during the 2018-2019 school year (preference is given to sophomores and juniors). The youth should have at least a 2.0 GPA (recommended) and be able to commit to completing the seven-month program. Does the applicant meet these requirements?

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* 10. To be eligible for Youth Leadership Long Beach, the applicant must live or go to school in Long Beach and be a high school Sophomore (class of 2021), Junior (class of 2020), or Senior (class of 2019) during the 2018-2019 school year (preference is given to sophomores and juniors). The youth should have at least a 2.0 GPA (recommended) and be able to commit to completing the seven-month program. Does the applicant meet these requirements?

Youth Leadership Long Beach participants learn not by being taught lessons, but by experiencing, reflecting, and actively taking lessons from themselves and their peers. For the next few questions, please rate the strengths of the applicant in the following areas. (scale of 1-10; 10 being the highest possible rating)
Setting and pursuing their own goals.

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* 11. Setting and pursuing their own goals.

  1 - Not a Strength 2 3 4 5 6 - Exceptional
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Challenging themselves to step outside their comfort zone

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* 12. Challenging themselves to step outside their comfort zone

  1 - Not a Strength 2 3 4 5 6 - Exceptional
Rating
Adapting to new experiences

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* 13. Adapting to new experiences

  1 - Not a Srength 2 3 4 5 6 - Exceptional
Rating
Overcoming obstacles

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* 14. Overcoming obstacles

  1 - Not a Strength 2 3 4 5 6 - Exceptional
Rating
Working in diverse groups of people

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* 15. Working in diverse groups of people

  1 - Not a Strength 2 3 4 5 6 - Exceptional
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How long have you known the applicant and in what capacity?

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* 16. How long have you known the applicant and in what capacity?

Please describe the applicant's most important strengths:

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* 17. Please describe the applicant's most important strengths:

Please describe the applicants areas for growth:

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* 18. Please describe the applicants areas for growth:

We would like to learn about the character of the applicant. What makes them unique? What do they care about?

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* 19. We would like to learn about the character of the applicant. What makes them unique? What do they care about?

What do you think the applicant could gain from being involved in Leadership Long Beach?

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* 20. What do you think the applicant could gain from being involved in Leadership Long Beach?

Please take this opportunity to tell us anything additional that we should know about the applicant's background or life circumstances?

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* 21. Please take this opportunity to tell us anything additional that we should know about the applicant's background or life circumstances?

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