Summer Adventure Challenge Leadership Camp Application

2. Name*

3. Address*

5. City*

6. State*

7. Zip*

9. Email

10. Phone*

12. School Attending*

13. G.P.A.*

14. Highest Grade Completed*

16. Father/Guardian (Full Name)*

18. Mother/Guardian (Full Name)*

20. Activities (see instructions below)*

    List special activities in which you have participated including sports, honors, and community involvement.

22. Why do you want to participate in the program?*

24. Reference Letter (see instructions below*

    Please attach a reference letter from someone familiar with your academic, community, or personal history. NOT an immediate family member

26. Photo (see instructions below)*

    Please attach a current photo of yourself.

Leave This Blank:


27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit

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