LLJSLI Application Form

Student Information
Name
First Last
Address
Street Address Address Line 2 City State ZIP Code
Date of Birth
Date Format: MM slash DD slash YYYY
Home Phone
Cell Phone
Email
High School
Anticipated Graduation Date
Date Format: MM slash DD slash YYYY
Parent Information
Name
First Last
Cell Phone
Email
Why are you interested in applying for a Board position for the Live Like John Service and Leadership Institute?
List outside activities you plan to participate in for the upcoming school year (include sports, music, theatre, community service, clubs, etc.)
Which days of the week are best for you for the monthly meetings (Sept. – May)?
What do you hope to gain from involvement in the Service and Leadership Institute?
Have you been involved with volunteer/fundraising activities in the past? If so, please describe briefly.
If not, how do you think your skills will benefit the Institute?
Reference
Please provide a personal reference (adult age, non-family member):
Name
First Last
Address
Street Address Address Line 2 City State ZIP Code
Cell Phone
Email
Relationship
By submitting this form, I agree that if I am selected as a Board Member for the Live Like John Service and Leadership Institute, I will do my best to make all Board meetings and participate in other Board related activities. (If application is accepted, Live Like John will verify parental consent.)

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