Application for Service with the Kentucky Y-Corps
DUE IN THE Y OFFICE NO LATER THAN DECEMBER 31st, 2009
Please type all information in a word document to be e-mailed or printed and mailed/faxed.
Completed Applications may be mailed, faxed, or emailed to the following:
Kentucky YMCA
P.O. Box 4285
Frankfort, KY, 40604
fax: 502-227-7030
email: christina@kyymca.org
Those accepted to be a member of the Kentucky Y-CORPS pledge to:
*Complete a minimum of 50 hours of community service during the ’09-’10 school year.
*Raise, through donations, a minimum of $500 for the trip and the KY YMCA Scholarship Fund (due in 2 installments before the trip, NOT WITH APPLICATION).
*Keep in constant (monthly) contact with their Regional Director regarding their personal and school’s service.
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I. CONTACT INFORMATION
NAME
ADDRESS
CITY/STATE/ZIP CODE
HOME PHONE
CELL PHONE
EMAIL
GRADE FOR ’09-‘10 SCHOOL YEAR
SCHOOL FOR THE ’09-’10 SCHOOL YEAR
STUDENT YMCA ADVISOR
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II. COMMUNITY INVOLVEMENT AND LEADERSHIP
**Please list the clubs, leadership positions, sports, jobs, and conferences that you have been involved with since your freshman year (that you can rememberJ). Please also list any relevant awards or recognitions that you have received. (It’s appropriate and encouraged for you to list any Kentucky YMCA conferences that you have attended.)
III. COMMUNITY SERVICE INVOLVEMENT
**Please list any community service or volunteer work you have been involved with during your high school career. Please organize the project list in reverse chronological order – starting with the most recent project.
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IV. PERSONAL STATEMENT
Please submit a one-page (max.) essay that responds to ONE of the following topics and attach it to your application.
A. How has service (not just service with the Y, but any service) impacted your life?
B. If you could serve any group of people or place (ex. children with disabilities or Darfur, Africa) who/where would it be and why?
C. Outline your ‘Dream Service Project’ from beginning to end.