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Cobb Youth Leadership 2010-2011 Application
 The
Cobb Chamber of Commerce, under the direction of the Leadership Cobb Alumni
Association, sponsors the Cobb Youth Leadership program. Focusing on
developing leadership styles and skills, the participants meet city and
county leaders and interact with students from across Cobb County.
Each participant must be a high school junior for the school year 2010-2011
and a resident of Cobb County or attend a school in Cobb County.
Follow the link below to print out the required second portion of this
application.
**Click here to download the Participation
Commitment Form and Letter of Recommendation form.
Instructions:
This application must be completed in its entirety. Any
application that is incomplete will not be considered.
Please submit the completed form by
Friday, April 23, 2010.
Fields marked with an * are
required
BASIC INFORMATION
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| First Name* |
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| Last Name* |
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| Preferred Name* |
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Date of Birth |
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| Ethnicity |
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| Gender: |
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| Mailing Address* |
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| City* |
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| State* |
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| ZIP* |
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| Home Phone* |
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| Mobile Phone: |
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| Applicant Email Address* |
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| Family Email Address: |
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| Parents/Guardians Names* |
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| Emergency Number* |
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ACADEMICS |
| Expected grade level as of August 2010: |
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| High School: |
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| Grade Point Average: |
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| Academic Honors Received (please list) |
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CURRENT
EXTRA CURRICULAR ACTIVITIES |
| List here (1) school activities, clubs, athletic teams;
(2) community and volunteer activities; (3) employment if applicable: |
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LEADERSHIP EXPERIENCE |
| List offices/leadership positions held in clubs or
organizations, project you directed/initiated if applicable: |
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| Do you know a Leadership Cobb Graduate? (This is the
adult version of Cobb Youth Leadership |
Yes No |
| If yes, name and relationship: |
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| What personal characteristics/qualities do you have
that you feel give you the potential to be a leader? |
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How would you complete this sentence?
In ten years I see myself...
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| If you are selected, how could Cobb Youth Leadership
help you in achieving the above? |
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TUITION FEE
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A tuition fee of $400 is required to help offset the
cost of materials, meals and lodging. Leadership
Cobb Alumni Association may provide a scholarship (1
per year) to someone requiring financial assistance
based on need. (Check One) |
| I will not require financial assistance
in order to participate. |
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| I will require
financial assistance in order to participate.
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| Please explain why financial assistance is needed. (Must be completed by
parent or guardian. |
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Please note:
Your letter of recommendation from a teacher,
employer, or friend of the family should be sent separately
from your application.
Need help? Questions? Contact
Katie Edfeldt at
kedfeldt@cobbchamber.org or 770-859-2334.
Quicklinks
Site Resources
 to email this page to
friend or associate.
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