Junior Leadership Georgetown Application 2024/2025

Junior Leadership Georgetown is a program created to develop the next generation of Georgetown community leaders. This nine-month program for high school juniors and seniors is designed to strengthen participants’ leadership skills, community awareness and involvement. Junior Leadership Georgetown will provide participants with quality, relevant leadership training along with knowledge of community, needs and opportunities. It allows participants to form effective relationships with current, past, and future leaders in the community.

Dates and times for the program 4:30 pm - 6:45 pm most days.

September 7, 9:00 am - 12:00 pm - What is Leadership?
September 8, 1:00 pm - 5:00 pm - Ropes Course, using leadership skills
October 16, Daring to Lead
November 20, Social Services Day
December 11, Public Safety Day
January 15, Developmental Assets
February 19, Juvenile Services
March 12, Healthcare Day
April 16, Local Government Day
May 14, Final Speeches & Graduation Day

Goals

To build leadership skills and encourage civic engagement • To develop and strengthen leadership skills • To increase understanding of community needs and opportunities • To develop community pride • To motivate students for volunteer activities

Fees

Application Fee is $50.00 and is non-refundable. Once your child has been accepted into the program, please make check payable to the Georgetown Chamber of Commerce.

Contact Information

First Name *

Last Name *

Nick Name or Preferred Name

Address

Address Line 1

Address Line 2

City

Zip/Postal Code

School *

Grade *

Age *

Full Birth Date *

Your Cell Number *

Your E-mail *

Will you be employed during the program? *

Total hour per week? *

Food Allergies, if any (Attach another sheet if necessary) *

Extracurricular Activities, if any (Attach another sheet if necessary) *

Guardian #1 Information

Name *

Relationship to Student? *

Cell Number *

Alternate Phone *

E-mail *

Guardian #2 Information

Name *

Relationship to Student? *

Cell Number *

Alternate Phone *

E-mail *

Program Awareness & Personal Growth

Describe your leadership style and experiences so far. *

What are your plans after high School? ( Please explain your future goals whether it is work, college, trade school, major, etc.) *

Describe your volunteer experiences, if any. (Attach another sheet if necessary) *

Why do you want to participate in Junior Leadership Georgetown? *

What skills do you hope to gain from your participation in the program? *

How did you learn about Junior Leadership Georgetown? *

Is there anything else we should know about you? *

Requirements

I have reviewed the program schedule and cleared my calendar to participate in the Junior Leadership Georgetown Program. I commit to attending the kickoff retreat, all regular sessions, Fall Carnival, one volunteer activity and the graduation celebration. I have my guardian’s support as indicated below and we both have reviewed the Junior Leadership Georgetown Policy and Procedure Document and the Junior Leadership Georgetown Class Schedule. If selected, I will devote the time and resources necessary to complete the Program. Even though emergencies do arise, any participant missing more than four hours, for whatever reason, may be asked to withdraw from the Program. We agree to pay the $50 non-refundable application fee for the program.

Guardian Consent Acknowledgement *

I hereby grant full permission to Junior Leadership Georgetown and the Georgetown Chamber of Commerce to use my students photo and profile information from the Junior Leadership Georgetown application in any publication or advertising materials (printed or electronic). This consent also serves to waive all rights of privacy or compensation which I may have in connection with the use of my photograph or profile information. Please do not use my students photograph in any publication or advertising materials. Please do not use my students profile information from the Leadership Georgetown application in any publication or advertising materials.

Additional Documents

Upon the Chamber receiving your application you will be emailed a participant profile consent form. That will need to be returned to complete your application.

Student & Guardian Acknowledgement *

Student - I have read and understand what is required to be part of Junior Leadership Georgetown Program. Guardian - I have read and understand what is reqired for my student to be part of the Junior Leadership Georgetown Program.

Contact for this program.

Dana Sanders, dana@georgetownchamber.org 512.930.3535