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2012 YOUTH ALCOHOL AND DRUG ABUSE PREVENTION PROJECT (YADAPP) • CHANGING LIVES THROUGH LEADERSHIP 2012 YOUTH LEADER APPLICATION (DUE DATE: NOVEMBER 1, 2011 / PAGE 1 OF 3) Applicant Information Name: (first) ______________________________________________________ (last) _______________________________________________________________ Home address: (line 1) ____________________________________________________________________________________________________________________ (line 2) ______________________________________________________________________________________________________________________________ (city) ______________________________________________________ (state) ___________________ (zip) _____________________________________ College address: (line 1) __________________________________________________________________________________________________________________ (line 2) ______________________________________________________________________________________________________________________________ (city) ______________________________________________________ (state) ___________________ (zip) _____________________________________ Home phone: (_________) _____________________________________ College phone: (_________) _____________________________________________ Cell phone: (_________) _______________________________________ Primary e-mail: ________________________________________________________ Birthdate (month / day / year): ___________________________________________________________________________________________________________ Former/current high school: _____________________________________________________________________________________________________________ Current grade level (2011–2012): T-shirt size: २ Small २ High school २ College [and] २ Medium २ Large २ XL २ XXL २ Freshman २ Sophomore २ Junior २ Senior २ XXXL Work Schedule Information Youth Leaders will be required to travel to the conference location two days prior to the beginning of the conference to participate in a two-day training session that involves leadership training, experiential learning activities and making lots of new friends. The Youth Leader position involves serving in a leadership position for the conference. All Youth Leaders will work in pairs on a variety of tasks in addition to working in partnership with Junior Staff members and Conference Interns. Finally, all Youth Leaders are required to stay on site for the duration of the conference. Right now, do you foresee a reason preventing you from attending the pre-conference training? २ Yes २ No If you answered “yes,” please explain: __________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ Youth Leader Acknowledgement I am aware that the position of Youth Leader is an unpaid leadership position for the 2012 Youth Alcohol and Drug Abuse Prevention Project (YADAPP). I understand that this position involves basic aspects of group facilitation, experiential learning, and public speaking. If selected as a Youth Leader, I will support the mission of YADAPP while carrying out the responsibilities assigned to me. I also understand that, if selected, I am expected to attend a two-day training prior to the conference. This training will occur two days before the actual conference. Please print this application and sign the Internship Acknowledgement by entering your name below. Please note: If you are under the age of 18, you must also have a parent/guardian sign your printed application. Applicant signature: ___________________________________________________________________________ Date: ________________________________ Parent/guardian signature (if under 18): _______________________________________________________ Date: ________________________________ Youth Leader applications are due November 1, 2011. The mission of the Youth Alcohol and Drug Abuse Prevention Project (YADAPP) is to develop youth leadership in order to foster substance abuse and violence prevention efforts at the state, regional, and local level. 2012 YOUTH ALCOHOL AND DRUG ABUSE PREVENTION PROJECT (YADAPP) • CHANGING LIVES THROUGH LEADERSHIP YOUTH LEADER APPLICATION 2012 (DUE DATE: NOVEMBER 1, 2011 / PAGE 2 OF 3) Applicant Short Answers Answer the following four questions regarding the Youth Leader position. Write/type your answer in the box below each question. You may also use a separate piece of paper. Good Luck! Question 1: Tell us about yourself! What are some of your hobbies/interests? How are you involved in your school/community? ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ Question 2: Youth Leadership. Why is youth leadership important to you? ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ Question 3: Select Your Question. Answer one of the following questions: (1) Describe your experience as a leader in your school and/or community; or (2) Describe the success or failure of your team’s STAN Plan from YADAPP 2011. ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ Question 4: Desire. Why do you want to be a Youth Leader and what do you have to offer YADAPP 2012? ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ Youth Leader applications are due November 1, 2011. The mission of the Youth Alcohol and Drug Abuse Prevention Project (YADAPP) is to develop youth leadership in order to foster substance abuse and violence prevention efforts at the state, regional and local level. 2012 YOUTH ALCOHOL AND DRUG ABUSE PREVENTION PROJECT (YADAPP) • CHANGING LIVES THROUGH LEADERSHIP YOUTH LEADER APPLICATION 2012 (DUE DATE: NOVEMBER 1, 2011 / PAGE 3 OF 3) Applicant Picture Please include a picture of yourself that does not need to be returned. If you aren’t the only person in the picture, please identify yourself. ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ AFFIX PICTURE HERE ___________________________________________________________________________ ___________________________________________________________________________ Important: Recommendation Forms Included with this application are two recommendation forms that need to be filled out by two different adults who are able to describe your abilities. These individuals may be your teachers, counselors, principal, employers, etc., but are not limited to those adults. After completing the recommendation form, the adults should return the form to you sealed in an enclosed envelope with their signature across the seal. Please give these forms and envelopes to your chosen adults allowing them adequate time to complete and return them to you in time to meet the postmark deadline. Application Submission Requirements Review your application for accuracy and completeness. Once finished, print and mail your complete application (including recommendation forms) to the Department of Alcoholic Beverage Control (ABC) / YADAPP Youth Leader Application, Attn: Steve Hammond, 2901 Hermitage Road, Richmond, VA 23220, with a postmark date no later than TUESDAY, NOVEMBER 1, 2011. Incomplete and late applications will not be accepted. All applicants will receive notification after selections have been made by late March. If you have any questions, please do not hesitate to contact Steve Hammond at 804-213-4498 or via email at education@abc.virginia.gov. Keep up-to-date about YADAPP by visiting www.yadapp.com. Also check out YADAPP on Facebook (keyword: YADAPP). Youth Leader applications are due November 1, 2011. The mission of the Youth Alcohol and Drug Abuse Prevention Project (YADAPP) is to develop youth leadership in order to foster substance abuse and violence prevention efforts at the state, regional and local level. 2012 YOUTH ALCOHOL AND DRUG ABUSE PREVENTION PROJECT (YADAPP) • CHANGING LIVES THROUGH LEADERSHIP 2012 YOUTH LEADER RECOMMENDATION FORM Applicant name: (first) __________________________________________________ (last) __________________________________________________________ Recommender name: (first)_____________________________________________ (last) __________________________________________________________ Phone: (_________) _________________________________ E-mail: ____________________________________________________________________________ Relationship to applicant: ________________________________________________________________________________________________________________ This applicant is applying to be a 2012 Youth Leader at the 27th annual Youth Alcohol and Drug Abuse Prevention Project (YADAPP). A Youth Leader is responsible for working in pairs with a team of high school students without constant and direct adult supervision. In addition, this position helps conference participants establish written action plans, develop presentations, and work on leadership skill development. Individuals in this position are called on to be role models, group facilitators, conflict managers and leaders in striking a balance between work and play. Question 1: Does this applicant take direction well and does he/she know when to exercise independent judgment and initiative? ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ Question 2: YADAPP is typically attended by a diverse group of 400 high school students from across Virginia. Youth Leaders are required to facilitate groups of other students and interact with adults as peers. Does this applicant possess the communication skills to interact with such an audience? ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ Question 3: How well does this applicant work under pressure? ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ Recommendation Submission Requirements Please return this form to the applicant in a sealed envelope with your signature on the seal. The applicant must turn in their application (including this form) with a postmark date no later than TUESDAY, NOVEMBER 1, 2011. Thank you for your time. Youth Leader applications are due November 1, 2011. The mission of the Youth Alcohol and Drug Abuse Prevention Project (YADAPP) is to develop youth leadership in order to foster substance abuse and violence prevention efforts at the state, regional and local level. 2012 YOUTH ALCOHOL AND DRUG ABUSE PREVENTION PROJECT (YADAPP) • CHANGING LIVES THROUGH LEADERSHIP 2012 YOUTH LEADER RECOMMENDATION FORM Applicant name: (first) __________________________________________________ (last) __________________________________________________________ Recommender name: (first)_____________________________________________ (last) __________________________________________________________ Phone: (_________) _________________________________ E-mail: ____________________________________________________________________________ Relationship to applicant: ________________________________________________________________________________________________________________ This applicant is applying to be a 2012 Youth Leader at the 27th annual Youth Alcohol and Drug Abuse Prevention Project (YADAPP). A Youth Leader is responsible for working in pairs with a team of high school students without constant and direct adult supervision. In addition, this position helps conference participants establish written action plans, develop presentations, and work on leadership skill development. Individuals in this position are called on to be role models, group facilitators, conflict managers and leaders in striking a balance between work and play. Question 1: Does this applicant take direction well and does he/she know when to exercise independent judgment and initiative? ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ Question 2: YADAPP is typically attended by a diverse group of 400 high school students from across Virginia. Youth Leaders are required to facilitate groups of other students and interact with adults as peers. Does this applicant possess the communication skills to interact with such an audience? ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ Question 3: How well does this applicant work under pressure? ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________ Recommendation Submission Requirements Please return this form to the applicant in a sealed envelope with your signature on the seal. The applicant must turn in their application (including this form) with a postmark date no later than TUESDAY, NOVEMBER 1, 2011. Thank you for your time. Youth Leader applications are due November 1, 2011. The mission of the Youth Alcohol and Drug Abuse Prevention Project (YADAPP) is to develop youth leadership in order to foster substance abuse and violence prevention efforts at the state, regional and local level.