Arapahoe & Mapleton Ys closed Thursday, May 26, 8:30am-12:30pm, Longmont & Johnstown Ys closed Thursday, May 26, 2:30-6:30pm

GLOBAL TEEN LEADERSHIP

APPLICATION

Student Information

Family Information

Additional Emergency Contacts

Health Information

Have you required any hospital treatment, including surgeries, in the past year?

Do you currently have ongoing health issues?

Participation Agreement

By checking the boxes below, you and your parent/guardian agree to the following:

Are there any health-released issues which might affect your fitness to travel?

I and my parent/guardian…
I and my parent/guardian…
I and my parent/guardian…
I and my parent/guardian…
I and my parent/guardian…
I and my parent/guardian…
I and my parent/guardian…
I and my parent/guardian…

Student Background

Please provide details of any previous or current volunteer or work experience.

Do you speak other languages?