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LLJSLI Application Form
Student Information
Name
First
Last
Address
Street Address
Address Line 2
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State
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Date of Birth
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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
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
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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