YOUTH SALUTE APPLICATION DOWNLOAD – Application Packet & Directions Please enable JavaScript in your browser to complete this form.1Contact Information2Leadership Roles, Activities, & Honors3Student Biography4Leadership Essay5Submit*Please have your student biography and leadership essay ready to COPY & PASTE when you fill out this application. Instructions for the student biography and leadership essay can be found in the application packet ABOVE.High School *Pick your school....OtherAnderson County High SchoolBath County High SchoolBerea Community High SchoolBourbon Christian AcademyBourbon County High SchoolBoyle County High SchoolBryan Station High SchoolBurgin Independent High SchoolCalvary Christian SchoolCarter G. Woodson AcademyCasey County High SchoolChristian Academy Of LawerenceburgDanville Christian AcademyDanville High SchoolEast Jessamine High SchoolEstill County High SchoolFleming County High SchoolFrankfort Christian AcademyFrankfort High SchoolFranklin County High SchoolFrederick Douglass High SchoolGarrard County High SchoolGeorge Rogers Clark High SchoolGreat Crossing High SchoolHarrison County High SchoolHenry Clay High SchoolHenry County High SchoolHome SchoolKY School for the DeafLafayette High SchoolLewis County High SchoolLexington Catholic High SchoolLexington Christian AcademyLexington Latin SchoolLincoln County High SchoolMadison Central High SchoolMadison Southern High SchoolMenifee County High SchoolMercer County High SchoolModel Lab High SchoolMontgomery County High SchoolNicholas County High SchoolOwen County High SchoolParis High SchoolPaul Laurence Dunbar High SchoolPowell County High SchoolPulaski County High SchoolRowan County High SchoolRussell Independent High SchoolSayre SchoolScott County High SchoolShelby County High SchoolSomerset Christian SchoolSomerset High SchoolSpencer County High SchoolSTEAM AcademySummit Christian AcademyTates Creek High SchoolTrinity Christian AcademyWashington County High SchoolWest Jessamine High SchoolWestern Hills High SchoolWoodford County High SchoolSchool Name *Student First Name *Student Last Name *Student Contact Information Student Home Address *City *State *Zip *Student Phone Number *Student Email *EmailConfirm EmailA copy of your application will be sent to the email address entered here.Parent/Guardian Contact InformationFirst Name - Primary Parent/Guardian (Best Contact Person) *Last Name - Primary Parent/Guardian *Phone Number - Primary Parent/Guardian *Email - Primary Parent/Guardian *EmailConfirm EmailFirst Name - Secondary Parent/GuardianLast Name - Secondary Parent/GuardianPhone Number - Secondary Parent/GuardianEmail - Secondary Parent/GuardianEmailConfirm EmailNext2 QUALIFYING LEADERSHIP ROLESStudents must have held or currently hold 2 leadership roles to which they were chosen by their peers or an adult leader within the past two years in school, religious or community sponsored organizations. Spell out complete names of clubs and organizations, no abbreviations. Explain your role in each with detail. These items are used for winner selections.QUALIFYING LEADERSHIP ROLE 1 (Organization/Role/School Year/Details) *QUALIFYING LEADERSHIP ROLE 2 (Organization/Role/School Year/Details) *ADDITIONAL LEADERSHIP ROLES, ACTIVITIES, & HONORSUse the fields below to LIST all other leadership roles, activities, and honors you would like the committee to know about. You may enter (and we encourage) multiple items per field. Fields may be left blank if they do not apply to you. Spell out complete names of clubs and organizations, no abbreviations. Explain your role in each with detail. These items are used for winner selections.SCHOOLSTATE/NATIONALVOLUNTEER SERVICESPORTSCOMMUNITYRELIGIOUSPreviousNextType (or copy & paste) your student biography in the field below. In a LIST, no paragraphs. *PreviousNextCopy & paste your Leadership Essay in the field below. *This item is used for winner selections. PreviousNextParent/Guardian Agreement - The information contained herein is correct. I hereby give consent for all information provided herein and photographs taken of the student in conjunction with the Youth Salute program to be used for publicity/social media/website, and display in school/community by Holifield Photography. I hereby release the National Council on Youth Leadership, the Central Kentucky Council on Youth Leadership, Holifield Photography, their employees and volunteers, from any liability resulting from injuries or illness sustained while participating in the Youth Salute program. *Parent/Guardian Name and DateStudent Agreement - The information contained herein is correct. I understand that false or misleading information contained in this application may be grounds for exclusion from the Youth Salute program and loss of any scholarships or awards received. I have read the program requirements listed above and agree to participate in all activities of the Youth Salute recognition. I hereby give consent for all information provided herein and photographs taken of myself in conjunction with the Youth Salute program to be used for publicity/social media/website, and display in school/community by Holifield Photography. *Name and DateSchool Counselor - We will contact your school counselor to verify your 3.0 GPA status (end of your sophomore year). Any student that does not meet the required GPA will be notified and will not be able to participate in Youth Salute. *EmailConfirm EmailSchool Counselor EmailHow did you hear about Youth Salute?... *School CounselorTeacherSchool AnnouncementSigns at schoolFriendFamilyClass 101Do you have a sibling that participated in Youth Salute in the past? *YesNoSecurity Question - Lets make sure you're not a robot... * = PhoneSubmit