JUNIOR LEADERSHIP MANATEE

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JUNIOR LEADERSHIP MANATEE P.O. BOX 1491 BRADENTON, FLORIDA 34206-1491 www.juniorleadershipmanatee.org Thank you for your interest in Junior Leadership Manatee! To be considered for participation in Junior Leadership Manatee (JLM) you must: 1. Be a high school sophomore at the time of application deadline and be a high school junior at the time of the start of the JLM program. Must attend school in Manatee County or be a resident of Manatee County. 3. Have, at minimum, a 2.5 unweighted GPA. 4. Have the written endorsement of your high school principal and your parent/guardian. 5. Agree to attend the MANDATORY Orientation and attend ALL JLM monthly program days. 6. Complete all attached paperwork correctly and submit on or before the deadline. ATTENDANCE POLICY JLM is a short program of only seven program days (one Saturday and 6 weekdays spread over 7 months). The JLM Board of Directors strongly believes that the integrity of the program is compromised if a student misses more than one session. Most JLM program days are held on days when the Manatee County public schools are scheduled off. (This schedule is subject to change if the school district schedule changes due to make up days, etc.) If a student is accepted into JLM and misses more than one program day, the student will not graduate from the JLM program. Attendance at Orientation is MANDATORY to participate in the program. REFERENCE FORMS Give the reference forms to two adults outside of your family who will serve as your references. Please have them fill out the reference forms and mail everything together with the completed application to the address listed throughout this packet. The Application must be postmarked by July 21, 2017. Do not send the program participant fee with your application. This fee will be due if you are accepted into the program. FINANCIAL ASSISTANCE A limited amount of financial assistance is available to participate in the JLM program and is based on economic need. Please attach a separate sheet outlining the circumstances surrounding your need. A request for financial assistance must be submitted with the application and contain the same parent/guardian signature as reflected/shown on the application form. For more information, please e mail chair@juniorleadershipmanatee.org.

This document contains a total of eleven pages: Cover Letter and Schedule (pages 1-2) Application Form (pages 3-5) Essay Form (page 6) Required Signatures (page 7) Personal Reference Form #1 (pages 8-9) Personal Reference Form #2 (pages 10-11) Mail the entire completed packet (minus the Cover Letter and Schedule) to the address listed below. If you are selected to participate you will be required to send the participation fee ($150) along with a completed Acceptance Agreement, Health Form, and Authorization and Treatment Form. You will also be required to participate in Teen Court prior to Government & Law Enforcement Day. (These forms will be provided at the appropriate time with further instructions and deadlines if you are accepted in the program.) 2017-2018 JLM SCHEDULE September 16 Orientation (mandatory for students) October 13 Government & Law Enforcement October 23 Business and Industry November 10 Media January 15 Health and Human Needs February 19 Agriculture and Land Use March 16 Culture and Recreation April 12 Graduation (location to be determined) Program Agendas will be posted on the website and e-mailed one week prior to the scheduled day. There are attire requirements for each Program Day. Please check your email or visit the website for exact times and details for each day. Snacks and lunch are provided each Program Day. If you have questions, please e mail chair@juniorleadershipmanatee.org

APPLICATION FORM APPLICATION DIRECTIONS 1. PLEASE TYPE OR PRINT IN BLUE OR BLACK INK. 2. INCOMPLETE APPLICATIONS OR FAILURE TO FOLLOW DIRECTIONS WILL RESULT IN NONCONSIDERATION. 3. ALL APPLICANTS MUST HAVE TWO (2) REFERENCES (FORMS & REQUIREMENTS PROVIDED). TRANSPORTATION Parents are responsible for transportation of the students to/from the meeting sites. Transportation throughout each Program Day will be provided by charter bus by JLM. PARTICIPANT FEE Applicants who are selected for JLM will pay a $150.00, non refundable participant fee. A limited amount of financial assistance is available. A request for financial assistance must be submitted with the application and contain the same parent/guardian signature as reflected/shown on the application form. ATTENDANCE In order to achieve the objectives of Junior Leadership Manatee, attendance at Orientation Day is MANDATORY and the student may not miss more than one program day. If selected for this year s Junior Leadership Manatee program, do you commit to attend ALL the program sessions? Yes No, explain: PERSONAL INFORMATION NAME: (LAST) (FIRST) (MIDDLE) HOME ADDRESS: CITY: ZIP CODE: PHONE: PARENT EMAIL: STUDENT EMAIL: (both parents AND students will receive emails regarding program day agendas and other related JLM business) How long have you lived in Manatee County? How did you hear about Junior Leadership Manatee? Please provide your shirt size below (unisex S, M, L, XL). If you are selected for the program you will receive a JLM Shirt at Orientation: Please circle: S M L XL

SCHOOL EXPERIENCE (Students apply in their sophomore year; attend in their junior year.) SCHOOL: GRADE: Is your grade point average (GPA) 2.5 or above (unweighted)? YES NO GENERAL INFORMATION (Please attach separate sheets if necessary) Using a few phrases or adjectives, please describe yourself. What is your favorite course and why? What are your educational, personal, and career goals? You are at your ten year high school reunion, describe yourself. List any hobbies or special interests you have. Why would you like to participate in the Junior Leadership Manatee program? What other things do you think make you a good candidate for the Junior Leadership Manatee program?

ORGANIZATIONS AND ACTIVITIES Please list, in order of importance to you, up to five school, volunteer, religious, social, athletic, or other activities/organizations in which you have participated during the last two years. 1. 2. 3. 4. 5. Activity/Organization Hours/week Leadership Position Held Please describe the reasons why you consider the number one activity listed above as most important to you. WORK EXPERIENCE Do you currently have a job? Yes No List any job experience (paid or volunteer) you had/have and briefly tell what was/is involved. During the School Year Hours/week Responsibility During the Summer Hours/week Responsibility If extraordinary circumstances prevent you from participating in organizations/activities or work, please explain below.

ESSAY ESSAY DIRECTIONS 1. YOUR ESSAY MUST BE TYPED, DOUBLE SPACED, 12 PT FONT. 2. NOT TO EXCEED ONE TO TWO PAGES PER PROBLEM. On separate sheets of paper, please answer the following: Identify what you believe to be the two (2) most pressing problems facing Manatee County today. Explain why you feel that way and make recommendations for addressing and resolving these problems.

JUNIOR LEADERSHIP MANATEE P.O. BOX 1491 BRADENTON, FLORIDA 34206-1491 www.juniorleadershipmanatee.org REQUIRED SIGNATURES APPLICANT/PARENT/GUARDIAN The applicant and his/her parent/guardian make a commitment to full and active participation in the Junior Leadership Manatee Program. Applicant Signature Date Parent/Guardian Signature Date PRINCIPAL As Principal of the applicant s school, I am aware of his/her interest in participating in the Junior Leadership Manatee program and have verified this student has an unweighted GPA of 2.5 or above. In addition, we have reviewed the attendance requirements and agree to abide by these requirements for the duration of the program. Principal Name Principal Signature Date Should you have any questions, please contact chair@juniorleadershipmanatee.org

JUNIOR LEADERSHIP MANATEE P.O. BOX 1491 BRADENTON, FLORIDA 34206-1491 www.juniorleadershipmanatee.org PLEASE TYPE OR PRINT IN BLUE OR BLACK INK. REFERENCE FORM #1 TO THE APPLICANT: Fill in your name below and give this form to an individual outside of your family who will serve as your reference. You will need two (2) references and only one reference may be from someone employed at your school. NAME: (FIRST) (MIDDLE) (LAST) TO THE REFERENCE: The above applicant for Junior Leadership Manatee has selected you as a reference. The JLM Selection Committee is very interested in the statements that you make in regard to this applicant. The Committee is aware of the time necessary to prepare this assessment and gratefully acknowledges your help. NAME OF REFERENCE: POSITION OR TITLE: FIRM/ORGANIZATION: ADDRESS: CITY: ZIP CODE: HOME PHONE: WORK PHONE:

PLEASE ANSWER THE FOLLOWING. For how long, and in what capacity, have you known this applicant? What are the first words that come to your mind when describing the applicant? What do you consider to be the applicant s primary talents or strengths? Please comment on the applicant s respect for adults. Please comment on the applicant s relationship with his/her peers. I recommend this student: with reservations fairly strongly strongly enthusiastically

JUNIOR LEADERSHIP MANATEE P.O. BOX 1491 BRADENTON, FLORIDA 34206-1491 www.juniorleadershipmanatee.org PLEASE TYPE OR PRINT IN BLUE OR BLACK INK. REFERENCE FORM #2 TO THE APPLICANT: Fill in your name below and give this form to an individual outside of your family who will serve as your reference. You will need two (2) references and only one reference may be from someone employed at your school. NAME: (FIRST) (MIDDLE) (LAST) TO THE REFERENCE: The above applicant for Junior Leadership Manatee has selected you as a reference. The JLM Selection Committee is very interested in the statements that you make in regard to this applicant. The Committee is aware of the time necessary to prepare this assessment and gratefully acknowledges your help. NAME OF REFERENCE: POSITION OR TITLE: FIRM/ORGANIZATION: ADDRESS: CITY: ZIP CODE: HOME PHONE: WORK PHONE:

PLEASE ANSWER THE FOLLOWING. For how long, and in what capacity, have you known this applicant? What are the first words that come to your mind when describing the applicant? What do you consider to be the applicant s primary talents or strengths? Please comment on the applicant s respect for adults. Please comment on the applicant s relationship with his/her peers. I recommend this student: with reservations fairly strongly strongly enthusiastically