Student applied leadership application

indicates a required answer

Thank you for your interest in the Student applied leadership program. Below is the application that each student interested in participating in the program will have to fill out and submit. If you have any questions please EMAIL me.

1. *	Email Address

2. *	Name

3. *	Phone number

4. *	Please tell me your interests and goals in joining the Uplift Student Applied Leadership program.

5. *	What are your strenghts, skills, and interests that you would like to excel in?

6. *	How much time a week do you have to put towards this program?

7. *

Uplift has areas that we can use help. Please select the areas that interest you.

(1 required)

Social media		Administration
Facility maintenance		Teaching
Organization		Public speaking
Media		Event planning
Other - please reach out to me

8. *	By signing I commit to the program
	By typing my name below, I understand and agree that this form of electronic signature has the same legal force and effect as a manual signature.