program application

JUNIOR LEADERSHIP ORANGE
Junior Leadership Orange is a program for eighth grade students that strives to identify up-and-coming
youth leaders by providing them with knowledge and skills that foster vision that they will ultimately
use to strengthen their communities. This is a highly selective process, with a limited number of
students accepted from each Orange County school district.
Do not let that discourage you from applying!
Youth who show leadership qualities in either in-school and/or out-of-school activities will be selected. The goal for this
program is to bring together a diverse group of youth who are leaders within their school based programs/activities with
youth who are leaders outside of their school setting.
Before applying, we ask that you carefully consider the following important points:
 To participate, youth will miss seven school days over the course of the school year. Any work missed while taking
part in this program must be made up.
 This is a participatory, interactive program. You will be expected to be an ACTIVE participant, taking part in
conversations, interactive games etc.
Junior Leadership Orange Program Overview:
The program kicks off with a “Family Information Session" during the summer for selected youth and their
parent/guardian(s). Final details are laid out and questions and concerns will be addressed. In September, the program
begins with an orientation day for students. This is an enjoyable Wednesday fieldtrip when youth from throughout Orange
County spend the day getting to know one another while participating in interactive ice-breaking activities. The program
continues to meet on the second Wednesday of the following months: October, November, December, February, March
and May (unless otherwise specified). Participants will be traveling to various locations throughout Orange County and
spending their day immersed in programs and interactive activities related to the day’s theme. At each session, instructors
and facilitators will present and engage participants in fun and interactive activities with the class. Presenters will represent
leaders from a variety of sectors in Orange County, such as law enforcement, non-profit organizations, government, and
business. Participants will bring home an agenda and are encouraged to share details about their day with their
parents/guardians. The program concludes with a celebratory graduation for family and friends in April.
There is no cost to schools, students or families! This program is sponsored by generous contributions made by area
businesses, organizations and individuals who wish to make an investment in youth and the future of Orange County.
Transportation and meals are provided for all sessions.
Junior Leadership Orange is the product of a longtime collaboration and partnership that began in 2011 between Leadership
Orange and The Orange County Youth Bureau. We hope you will take this time to apply for placement in this prestigious
program for eighth grade students and serve as a representative for your school district!
Please complete the attached two page Program Application and submit it with the completed 2-page Recommendation
Form. For additional information contact Karolyn Thompson at 845.562.8500 or via email [email protected]
DEADLINE FOR SUBMISSION IS APRIL 30, 2017
www.leadershiporange.org
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PROGRAM APPLICATION
PROGRAM APPLICATION MUST BE COMPLETED BY STUDENT (NOT PARENT AND/OR GUARDIAN)
Please type or print clearly and answer each section completely. APPLICATIONS IN PENCIL WILL NOT
BE ACCEPTED.
Applicant’s Name:
Home Phone:
(
)
-
Cell Phone:
(
)
-
Email:
Mailing Address:
City:
Name of School (you must be in 8th grade for the 2017-2018 year):
School District:
State:
Zip:
Name of School you attend (include if private school, homeschooling, etc.): __________________________________
1. Please tell us a little about yourself: Include any special interests/skills, hobbies, jobs, volunteering you may have done,
any groups/teams you may be a part of (whether in school and out of school).
2. Please tell us why you want to join the Junior Leadership Orange Program: Include what you hope to get out of your
experience in the program.
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Applicant’s Name:
Supporting Documentation:
1. Have a Teacher, Guidance Counselor or Principal certify this application by completing and signing below:
,
,
(Name)
(Title)
I confirm that based on my observations,
,
will not have trouble making up work missed while attending this program for seven separate days over the course of the school
year and that this student will be entering 8th grade in September of 2017.
Signature of School Rep:
Date:
/
/
Email:
2. Have your parent /guardian read this portion and sign below:
I am aware that my child;
, is applying for the Junior Leadership
Orange Program. If selected, I understand that we both must be in attendance at a Family Informational Session that will be scheduled over
the summer months. (Please note that you will be given 2 dates and times to choose from.) I understand that this program is NOT just for
traditional leaders. The basis for this initiative is to serve well behaved youth who have demonstrated leadership qualities in either a
traditional or less traditional sense, and may not otherwise have an opportunity to participate in this type of program. In order to participate,
my child will miss seven school days over the course of the school year and any work missed while taking part in this program must be made
up. This is a participatory, interactive program for students who enjoy that type of setting. Youth are expected to be ACTIVE participants,
taking part in conversations, interactive games etc.
Parent/Guardian Name (print):
Home Phone:
(
)
-
Cell:
(
)
-
Email:
I acknowledge that my child completed this application on his/her own ____Yes
____
Parent/Guardian Signature:
Date:
/
/
3. Please have an adult who is not related to you, complete the required “Recommendation Form”. This person should be able to give
examples of how you have demonstrated leadership qualities. Remember; leadership can be expressed in many different ways – whether it
has been in school or out of school. The Recommendation Form MUST be returned in a sealed envelope and mailed to Leadership
Orange, Desmond Campus, 6 Albany Post Road, Newburgh, NY 12550.
Important Checklist:
Fill out page one completely, including a paragraph detailing the reason(s) that you are applying to the Junior Leadership Program
Get a Teacher, Guidance Counselor or Principal to certify this application by signing and dating it
Get your parent/guardian to sign and date this application
Attach the required Recommendation Form, completed and signed by person recommending you
I will be entering the 8th grade in September 2017
Parent emailed had been filled out. This is a MUST!
If yes to all, please sign and date below. Please Note: late or incomplete applications will not be accepted
Applicant’s Signature:
Date:
_______________
Return complete Application Packet and Sealed Recommendation Form, to:
LEADERSHIP ORANGE
Desmond Campus
6 Albany Post Road, Newburgh, NY 12550
845.562.8500
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Junior Leadership Orange Recommendation Form
To be completed by a non-relative adult who can speak to applicant’s strengths (in-school and/or out-of-school) and reasons for
recommending youth for this leadership program.
Applicant’s Name:
Recommendation Submitted by:
Phone:
(
)____- __
Email : ___________________________________________________
Junior Leadership Orange is a program for eight grade students that strives to identify emerging young leaders, providing them with
knowledge and skills that foster vision that they will ultimately utilize to strengthen their local communities. This is a highly selective
process with limited slots from each Orange County school district. Selected youth will be active participants, taking part in
conversations, interactive games, etc. It is the goal of this program to be made up of a group of diverse youth leaders from both nontraditional and traditional settings.
EXAMPLES:
Non-traditional leadership: applicant might volunteer as an individual rather than with a formal group for charity events (i.e. breast
cancer walk), in a band (outside of school), helps a local animals shelter, etc.
Traditional leadership: applicant might participate in school groups, sports, scouts, faith based groups, etc.
What unique skills and abilities does this candidate possess that makes them a good example of a
Non-traditional or Traditional Leader (as described above). - Feel free to elaborate
You may attach up to one (1) sheet of additional information.
Date:
Signature
For additional information, please contact Karolyn Thompson 845.562.8500
[email protected] or visit the website at www.leadershiporange.org
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