Application for Youth Leadership Forum for Community Transformation 2026
Thank you for your interest in YLF! Please submit this registration, including a letter of recommendation from a trusted adult in your life. Questions can be sent to ibluper@occjok.org
Name
First Name
Last Name
Birthday
-
Month
-
Day
Year
Date
Pronouns
Race/Ethnicity 1
Race/Ethnicity 2
Gender
School
Expected Graduation Year
Email
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please note any dietary restrictions or needed accessibility accommodations
Parent/Guardian's Name
Parent/Guardian's Email
example@example.com
Parent/Guardian's Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Please list leadership activities you are involved in
Why are you interested in participating in the Youth Leadership Forum for Community Transformation?
If you were to rate race relations in the United States from 1-10 (with 1 being "awful" and 10 being "excellent), how would you rate it, and why?
If you were to rate race relations in your school or community from 1-10 (with 1 being "awful" and 10 being "excellent), how would you rate it, and why?
Letter of Recommendation
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