blyap application form
DESCRIPTION
Dear Youth Leader, The BoldLeaders Youth Ambassador Program funded by the United States Department of State and overseen locally by the US Embassy of Trinidad and Tobago invites youth 15-18 Years to apply for the 2013 and 2014 Program. A life changing experience and a lifetime of service begins with a one month exchange to the United States. The exchange allows youth to:• Develop and understand their basic human resources • Participate in skills-based trainings• Engage with local government & organizations• Interact with their peers from other countries • Experience different cultures and norms Travel Dates:October 2013 February 2014 What are the Requirements?• Enrolled in secondary school• Between the ages of 15 and 18• Outstanding school record• From family with limited economic means• Display leadership qualities• Demonstrated interest in improving local communityPlease note:Students turning 15 on or before the 1st of October 2013 or the 1st of February 2014 can apply Students turning 19 on or before the 30th of October or the 28th of February cannot apply.Applications Guidelines:Completed applications must be submitted by midnight March 31st 2013 to [email protected] with the Subject: NAME – BLYA APPLICATION e.g JANE DOE - POATT APPLICATIONWe look forward to receiving your application. Regards, BoldLeaders Youth Ambassadors TeamTRANSCRIPT
BOLDLEADERS YOUTH AMBASSADOR PROGRAM 2013/2014
APPLICATION FORM
Dear Youth Leader,
The BoldLeaders Youth Ambassador Program funded by the United States Department of State and overseen locally by the US Embassy of Trinidad and Tobago invites youth 15-18 years to apply for the 2013 and 2014 program. A life changing experience and a lifetime of service begins with a one month exchange to the United States. The exchange allows youth to:• Develop and understand their basic human resources • Participate in skills-based trainings• Engage with local government & organizations• Interact with their peers from other countries • Experience different cultures and norms Travel Dates:October 2013 February 2014 What are the Requirements?• Enrolled in secondary school• Between the ages of 15 and 18• Outstanding school record• From family with limited economic means• Display leadership qualities• Demonstrated interest in improving local community
Please note:Students turning 15 on or before the 1st of October 2013 or the 1st of February 2014 can apply Students turning 19 on or before the 30th of October or the 28th of February cannot apply.
Applications Guidelines:
Completed applications must be submitted by midnight April 7th 2013 to [email protected] with the Subject: NAME – BLYA APPLICATION e.g JANE DOE - BLYA APPLICATION
We look forward to receiving your application.
Regards,
Youth Ambassadors Team
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BOLDLEADERS YOUTH AMBASSADOR PROGRAM 2013/2014
APPLICATION FORM
Instructions: Carefully read the requirements for this program and legibly complete this form
Applicant Information
First Name Middle Name Family Name
Home Address
Male Age Date of Birth (Mo/Day/Yr) Country of Birth
Female
Home Telephone Mobile Number E-Mail Address
Family Information: Parent/Guardian
Father’s Name Occupation Name of Company
Home Address
Business Numbers Cell Number E-Mail Address
Mother’s Name Occupation Name of Company
Home Address
Business Number Cell Number E-Mail Address
Education: Present School
School Name
Address
Form Teacher Name Contact Number
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BOLDLEADERS YOUTH AMBASSADOR PROGRAM 2013/2014
APPLICATION FORM
CXC Qualification (Subjects & Grades )
If you have not sat CXC, list subjects you are presently pursuing and your last term’s grades
List other Qualification / Certification
Why are you the most suitable candidate for the BoldLeaders Youth Ambassadors Program 2013/2014?
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BOLDLEADERS YOUTH AMBASSADOR PROGRAM 2013/2014
APPLICATION FORM
In keeping with our theme, “I am Bold – Rising Beyond Challenges”, not exceeding 400 words state what has been your greatest challenge in life to date?
State how you have or intend to contribute to your community/country?
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BOLDLEADERS YOUTH AMBASSADOR PROGRAM 2013/2014
APPLICATION FORM
Are you involved in any 1) school activities 2) community activities 3) sporting activities 4) religious groups?
Yes
No
If yes please state which ones and exactly how you contribute:
Have you ever travelled to the United States of America?
Yes
No
If yes, please state the last time and the purpose of your visit
Do you have any immediate family residing in the United States of America?
Yes
No
If yes, please state name (s), their relationship to you and the state they reside in?
Please provide your Reference Contact Details:
(Someone who can elaborate on your character eg. a teacher, a pastor, a coach)
Name:
Address:
Relationship to you:
Contact Numbers:
Email address:
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BOLDLEADERS YOUTH AMBASSADOR PROGRAM 2013/2014
APPLICATION FORM
I acknowledge that the information presented above is a true representation of the applicant. I also acknowledge that if selected further background checks will be done and if any discrepancies are found this will automatically forfeit my child/ward ability to participate in the Youth Ambassadors Program.
Parent/ Guardian Applicant
Date Date
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