EBLI Application

Please complete the following application to apply for EBLI. The application deadline has been extended to February 6, 2008. Applications must be completed by this date. If you have any questions about or trouble with the application, please contact Ken Hussey at khussey@jcymca.org.

Please note the following:

  • This form works best when JavaScript is enabled.
  • All items marked with an asterisk (*) must be filled out to complete your application.
Student Information
* First Name:
* Preferred Name:
* Last Name:
* Sex:
  
* High School Graduation Year:


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Delegation Information
* Select Delegation:
Please select your DELEGATION from the drop-down menu.

If your DELEGATION is not in the menu, please select "Not Listed" and type your delegation's name in the text box below the menu.
* Delegation:

EBLI Application
Please select your top three department preferences for EBLI. If you are selected for EBLI, we will try to place you in one of these departments. However, this is no guarantee that you will be placed in one of these departments.
Department - 1:
Department - 2:
Department - 3:
Please briefly describe your school and community extracurricular activities.
Please write a 250 word or less personal statement about why you would like to participate in EBLI.

Review of Participant Handbook
* I have reviewed the Participant Handbook, Program Handbook, and Student Participation Agreement. I agree to abide by all the rules and requirements set forth by Missouri YMCA Youth In Government. I have reviewed and met the qualifications for and will fulfill the duties of any leadership position that I am applying for by submitting this application.
Please check the box indicating that you have read and agree with the above statement. Your application will not be accepted without checking this box.





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