Youth Leadership Long Beach Class of 2020 Reference Form

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 July 1, 2019.

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* 1. Your Title

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* 2. Your Name

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* 3. School or Organization

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* 4. Your Address

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* 5. City, State, and Zipcode

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* 6. Work Phone

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* 7. Work E-mail

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* 8. Student Applicant's Name

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* 9. Student Applicant's High School

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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 2022), Junior (class of 2021), or Senior (class of 2020) during the 2019-2020 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?

Yes

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)

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* 11. Setting and pursuing their own goals.

	1 - Not a Strength	2	3	4	5	6 - Exceptional
Rating	Rating 1 - Not a Strength	Rating 2	Rating 3	Rating 4	Rating 5	Rating 6 - Exceptional

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* 12. Challenging themselves to step outside their comfort zone

	1 - Not a Strength	2	3	4	5	6 - Exceptional
Rating	Rating 1 - Not a Strength	Rating 2	Rating 3	Rating 4	Rating 5	Rating 6 - Exceptional

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* 13. Adapting to new experiences

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

Comment

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* 14. Overcoming obstacles

	1 - Not a Strength	2	3	4	5	6 - Exceptional
Rating	Rating 1 - Not a Strength	Rating 2	Rating 3	Rating 4	Rating 5	Rating 6 - Exceptional

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* 15. Working in diverse groups of people

	1 - Not a Strength	2	3	4	5	6 - Exceptional
Rating	Rating 1 - Not a Strength	Rating 2	Rating 3	Rating 4	Rating 5	Rating 6 - Exceptional

Comments

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* 1. Your Title

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* 2. Your Name

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* 3. School or Organization

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* 4. Your Address

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* 5. City, State, and Zipcode

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* 6. Work Phone

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* 7. Work E-mail

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* 8. Student Applicant's Name

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* 9. Student Applicant's High School

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* 11. Setting and pursuing their own goals.

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* 12. Challenging themselves to step outside their comfort zone

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* 13. Adapting to new experiences

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* 14. Overcoming obstacles

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* 15. Working in diverse groups of people

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

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

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* 18. Please describe the applicants areas for growth:

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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?

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

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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?