Youth Leadership Camp Application

Applicant Information

Name

As it appears on your Driver's License or ID

Phone

Mailing Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Can you send and receive text messages?

Yes

Age

Gender

Male

Female

Date of Birth

Shirt Size

Small

Medium

Large

Parent's Information

Mother's Information

Name

Phone

Father's Information

Name

Phone

*The majority of information will arrive via email. Please make sure to check your emails on a regular basis.

School Information

School Name

Phone

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Principal

The following questions are used to help us make an informed decision regarding your interest and/or skills. We ask you to complete the following questions.

Have you ever attended Youth Leadership Camp? If yes when?

Why would you like to attend Energy Camp?

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