I have extra applications in my room if you are interested.
YOUTH LEADERSHIP FORUM
WHAT ISYLF?
The Youth LeadershipForum is a leadership and self-advocacy training for high school students withdisabilities from across the state, sponsored by the Tennessee Council onDevelopmental Disabilities.
WHATWILL THE SELECTED STUDENTS DO?
Attend sessions by localand national presenters on a variety of topics, including leadership,self-advocacy, planning for life after high school, employment, collegeresources for students with disabilities and the legislative process.
Students will also participatein:
*several small groupdiscussions about their lives, hopes and dreams
*a drumcircle
*a talent show
*a tour of the Capitol,including a conversation with a legislator
WHENWILL THE FORUM TAKE PLACE?
JULY 9-12, 2012
WHEREWILL IT TAKE PLACE?
Vanderbilt Universitycampus.
WHATDOES IT COST?
There is no cost for thetraining, sleeping rooms or meals. Students or their families will be reimbursed for mileage to and fromthe Forum approximately two weeks after the event.
WHO CANATTEND?
Rising tenth gradersthrough those students that will graduate in May or June of 2011. Students do not attend with family members.
WHO WILLSUPERVISE THE FORUM?
8-10 adult counselors andcoordinating staff; many are returning YLF graduates
HOW MANYSTUDENTS WILL BE SELECTED?
Twenty. An effort will bemade to select a diverse group, based on type of disability, ethnicity, gender,school year and region of the state the student lives in.
HOW DOESA STUDENT APPLY?
By completing theattached application, which includes essay questions and letters ofrecommendation. If the student cannot access the attached application, pleasecontact Ned Andrew Solomon at 615.532.6556, or by e-mail at ned.solomon@tn.govfor a mailed application.
WHAT ISTHE DEADLINE FOR APPLYING?
All applications must bepostmarked by March 1, 2012
For any other information about the Forum, please contact Ned AndrewSolomon at 615.532.6556, or by e-mail at ned.solomon@tn.gov
THE TENNESSEE YOUTH LEADERSHIP FORUM
TENNESSEE COUNCIL ON DEVELOPMENTAL DISABILITIES
The Tennessee Youth Leadership Forum, (YLF), is a four-day leadershipand self-advocacy training session that will take place July 9-12, 2012 atVanderbilt University in Nashville.
· Approximately 20 high school 10th, 11thand 12th graders with disabilities from across the state ofTennessee will be selected to attend.
· There is no charge to selected student delegates(all expenses paid, including reimbursement for travel to and from the Forum).
· Students, known as YLF Delegates, willparticipate in an educational four-day training program that includes: presentationsby local and national speakers in the field of disability, small and largegroup discussions on developing leadership skills and other disability-relatedtopics, a tour of the State capitol and a talent show.
APPLICATION FORM
DEADLINE FOR MAILED, FAXED or E-MAILED APPLICATION: March 1, 2012
STUDENTS MUST COMPLETE ALL SECTIONS OF THIS APPLICATION.
INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED
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_________________________________________________________ Male Female
Student’s Last Name First Middle Initial
_________________________ _______________________________
Please specify your ethnicity County of Residence
_____________________________________________________________________________-___
Residence Address City State ZIP (9 digits)
________________________________________________________________________________
Mailing Address, if different than above City State ZIP
_____________________________ ______________________________
Home Telephone Number Nameof High School
_____________________________ _____________________________________
Grade Level in March 2012 SchoolAddress
__________________________ _________________________ _______________________
City State ZIP High School Counselor’s Name SchoolTelephone Number
______________ _____________________
Birthdate Date Graduation Expected
Please describe your disability, or disabilities, in as muchdetail as possible. This information will assist in creating a diverse class.
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Please list any elective classes or extracurricularactivities you are currently enrolled in:
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
School andCommunity Involvement
Below, please briefly list your involvement with your schooland community. This may include anyoffices held, club memberships, after school activities, or workexperiences. List the grade level youwere in at the time of participation.
School activities oraccomplishments
Name of Activity GradeLevel
1.
2.
3.
4.
Community activitiesor accomplishments
Name of Activity GradeLevel
1.
2.
3.
4.
Letters of Recommendation
Please attach twoletters of recommendation, which describe your demonstrated leadershipskills or your leadership potential. Oneletter must be from a high school representative, and one must be from acommunity representative outside of your school. Please make sure the submitted letters listthe name, position/title, organization, and telephone number of the personwriting the recommendation.
ESSAY
Your answers to the following questions will be used toassess your readiness to participate in this leadership forum. Please writeyour responses on separate paper, and attach them to your completed applicationpacket. Even if the student requires the help of a parent or other assistant tocomplete this section, the responses must be in the student’s own words. Pleasecontact our office if the responses to these questions need to be submitted inan alternative format (i.e. audio or video tape.)
(a) QUALIFICATIONS-Explain why you feel you are qualified to be a delegate to this forum, andplease tell us why you want to attend.
(b) POSITIVEINFLUENCES- Please tell us about two people who have positively influencedyour life, and in what way(s) they have influenced you. (Families, teachers, counselors, friends,public officials or celebrities are appropriate examples.)
(c) EXPERIENCESAS A PERSON WITH A DISABILITY- Describe two important experiences you havehad as a young person with a disability. (Please be specific about your examples as they relate to yourdisability).
(d) FUTUREPLANS- Describe any of your plans following your high school graduation.
Please use the checklist below, to make certain your applicationpacket is complete. All questions must be answered, and requested letters andinformation provided.
Required Items
v Applicationform (3 pages)
v Twoletters of recommendation
v Essay(response to four topics)
_________________________________________________________
Signature of Student Date
Thank you for completing thisapplication.
Please mail, fax or e-mail it to the address below.
Ned Andrew Solomon,Director YLF
Council onDevelopmental Disabilities
Parkway Towers, Suite130
404 James RobertsonParkway
Nashville, TN37243-0228
Voice: 615.532.6556/TDD:615.741.4562/FAX 615.532.6964E-mail: ned.solomon@tn.gov
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