Teen Leadership Academy Application

Applicant First Name

Applicant Last Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Student Phone Number

Student Email

Parent/Guardian Phone Number

Parent/Guardian Email

Name of High School

Year in School

I am committed to attending all of the academy

Yes

No

I am currently enrolled in high school or similar level home-school program

Yes

No

I am a Chandler resident

Yes

No

I have transportation to and from City Hall Complex for the program

Yes

No

I have a strong work ethic and willingness to learn about the city

Yes

No

Applicant Essay

Please attach a short essay (500 words max) of why you want to attend the Teen Leadership Academy and what you would like to work to improve for teens in the greater Chandler community.
Upload requirements

Parent/Guardian

I commit to being a partner in my child’s participation in this program. I will ensure that he/she has adequate transportation and I will encourage my child to be punctual and attend all sessions. I give permission that any photo or video taken of my child can be used by the City of Chandler.

Yes

No

By selecting and submitting, I certify that I am the parent/guardian of the applicant, and give my permission for the applicant to participate in the Teen Leadership Academy as described.

Yes

No

All city records are subject to the State of Arizona public records law. Please note that any correspondence, such as application forms, e-mails or letters, sent to city officials or staff becomes public record and is available for public/media review.

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Teen Leadership Academy Application

Parent/Guardian