Class of 2021
Deadline: Monday, May 16, 201
Leadership River Falls Youth is a program that gives area 8th grade students a chance to enhance their knowledge and develop leadership skills that will empower and motivate them to become involved and committed to their community. Middle School students from the School District of River Falls, St. Bridget School, or who are home schooled, who will be in 8th grade during the 2016-2017 school year are eligible to apply. Selection Process The LRFY Selection Committee will select a maximum of 12 participants for the program based on your application and references. The Selection Committee will be unaware of the identity of the candidates. Participants will be notified of acceptance prior to the end of the school year. An orientation retreat will be held on August 24, 2016 for all participants and their parents or guardians. There is no cost for students to participate in this program.
How to Apply 1. Complete the first three pages of the application. If your application is not complete, your application may not be considered. 2. Sign your name at the bottom of page three. 3. Prepare and attach your essays to your application. 4. Request that your references complete the appropriate form and send them directly to the River Falls Area Chamber of Commerce or to their school counselor for submission. 5. Request that your high school principal complete the permission form (page six) and send it directly to the River Falls Area Chamber of Commerce or to a school representative.
Applications must be submitted by May 16, 2016.
Mail the completed application packet to: Maranda Mahr River Falls Area Chamber of Commerce 215 W. Maple St. River Falls, WI 54022
Deliver to your school representative: Jennifer Peterson Director of Academic Services School District of River Falls 852 East Division Street River Falls, WI 54022
Questions? Contact Maranda Mahr at (715) 425-2533 or via email
[email protected]
Class of 2021
Deadline: Monday, May 16, 2016
A program for students who will be in 8th grade during the 2016-2017 school year. Personal Information Name First
MI
Last
Preferred name
Birth Date
Home address Street Address
Home telephone Middle school
City
State
Zip
Email address _____________
Current Grade
outh Leadership Information How did you find out about Leadership River Falls Youth? At school Online From a friend Other How will you get to the off-site class sessions? Car Public transportation Other
References Please ask two people who know you well and can vouch for your character to complete the reference forms. Have them mail the completed reference forms directly to: Maranda Mahr River Falls Area Chamber of Commerce 215 W. Maple St. River Falls, WI 54022 Reference Form 1: Educator Reference must be completed by an educator. Reference Form 2: Community Reference must be completed by an adult (someone outside the school system and not a teacher, parent, or relative) with whom you interact in the community. It may be an employer, a community service coordinator, or a person who oversees an activity with which you are involved. Please indicate below the names of the persons who will be completing the Reference forms:
1
Class of 2021 Educator Reference:
Name: Position: Phone: Email: Community Reference:
Name: Position: Phone: Email: Check here if you would like to be notified via email when references are received in the LRFY office. Please respond to the following three (3) questions and attach your completed essays to your application. Be sure to type your response, using no less than 11-point type. Each essay should be submitted as a separate document. This essay will be an important part of the selection process.
Leadership River Falls Youth Describe what it takes to be a leader and provide an example of when you demonstrated one or more of these skills. (Maximum one page, double-spaced.)
Perseverance Every obstacle we face in life comes with an opportunity to learn something new. Describe a challenge that you have faced, how you persevered, and what you learned from the experience. (Maximum one page, double-spaced)
C. Future What do you see yourself doing in 10 years? (Maximum one page, double-spaced)
2
Class of 2021
Parent/Guardian Permission If accepted, my son/daughter has permission to participate in this program. I understand that this includes an initial retreat on August 24, 2016, and the following program days on September 9, October 10, November 11, January 16, February 20, March 24, and May 12. I understand, that the School District Administration of the School District of River Falls and St. Bridget School have approved these days as excused absences. I also give my permission for my son/daughter’s photo to be used on the River Falls Area Chamber of Commerce’s website and in marketing materials.
Name of parent/guardian (please print)
Signature
Date
Student Agreement I certify that the answers given herein are true and complete to the best of my knowledge. I am a student who will be in the 8th grade in the 2016-2017 academic year, who attends school at River Falls, St. Bridget School, or is a home schooled student with residence in the School District of River Falls. Attendance If selected, I commit to attending the opening retreat, all the sessions, and the graduation ceremony. Full attendance by each participant is essential for the Leadership River Falls Youth graduation. The program dates are August 24, September 9, October 10, November 11, January 16, February 20, March 24, and May 12. Photograph Release I also give my permission for my photograph to be used on the River Falls Area Chamber of Commerce’s website and in marketing materials.
Name of applicant (please print)
Signature of applicant
Date
If you are unable to mail the application to the Chamber office, you may leave your completed application with Jennifer Peterson, Director of Academic Services by May 16, 2016.
All applications and reference forms must be received by May 16, 2016.
3
Class of 2021 Reference Applicant will not be considered unless all forms are received by Monday, May 16, 2016.
o be completed by the applicant Name First
MI
Last
School I understand that the information provided by the reference will be kept confidential and will not be divulged to me at any time.
Signature of applicant
Date
o be completed by Educator Name First
School
MI
Last
Work Phone
Email
The above student is an applicant for Leadership River Falls Youth. The program is designed to enhance knowledge of and develop th leadership skills in a diverse group of area 8 grade students that empower and motivate them to become involved and committed to their community. The sessions feature a lively combination of speakers, small group experiences, tours, and a community service project. 1. Give examples of the applicant’s primary talents or strengths.
2. Give one example where this student can improve.
3. What would this student contribute to the program?
4. Why is this opportunity important to the student?
5. Does this student have the capacity to benefit from leadership training? Please explain.
___________________________________________
________________________
Signature
Date
Please mail this form by May 16, 2016 to: Maranda Mahr, River Falls Area Chamber of Commerce, 215 W. Maple St., River Falls, WI 54022 or hand in to the school representative. Do NOT return to the applicant. Call (715) 425-2533 or email
[email protected] if you have any questions.
Class of 2021
Community Reference Applicant will not be considered unless all forms are received by Monday, May 16, 2016.
o be completed by the applicant Name First
MI
Last
School I understand that the information provided by the reference will be kept confidential and will not be divulged to me at any time.
Signature of applicant
Date
Part II: To be completed by Community Reference (not a teacher, parent or relative) Name First
MI
Last
Address
Phone
Work
Relation to Student The above student is an applicant for Leadership River Falls Youth. The program is designed to enhance knowledge of and develop th leadership skills in a diverse group of area 8 grade students that empower and motivate them to become involved and committed totheir community. The sessions feature a lively combination of speakers, small group experiences, tours and a community service project. 1. How long and in what capacity have you known the applicant?
2. Give examples of the applicant’s primary talents or strengths.
3. Give one example where this student can improve.
4. What would this student contribute to the program?
5. Why is this opportunity important for the student?
6. Does this student have the capacity to benefit from leadership training? Please explain.
_______________________________________________
___________________
Signature
Date
Please mail this form by May 16, 2016 to: Maranda Mahr, River Falls Area Chamber of Commerce, 215 W. Maple St., River Falls, WI 54022 or hand in to the school representative. Do NOT return to the applicant. Call (715) 425-2533 or email
[email protected] if you have any questions.
Class of 2021
Permission Applicant will not be considered unless all Monday, May 16, 2016.
o be completed by the Principal All applicants must have approval from their current school principal to attend the sessions of Leadership River Falls Youth. Please have your principal sign below. I approve of the participation of _ _________________________________________ (student name) in the Leadership River Falls Youth Program for 2016-2017. The student meets the criteria of being academically sound and in good standing.
Principal Name School
Signature of Principal
Date
Please mail this form or deliver to one of the following school representatives:
Mail to: Maranda Mahr River Falls Area Chamber of Commerce 215 W. Maple St. River Falls, WI 54022
Deliver to: Jennifer Peterson – Director of Academic Services School District of River Falls 852 East Division Street River Falls, WI 54022
If you have questions, contact Maranda Mahr by May 16, 2016 at (715) 425-2533 or
[email protected]
