Form Test

  • (Include if private, homeschooling, etc...)
  • (Please provide an email that you check often, acceptance will be sent to this email address.)


  • Please answer the 4 questions below. You must answer each question. If you leave a question blank, your application will be considered incomplete and will be ineligible for consideration.



  • A School Guidance Counselor MUST be aware that you are applying for the Junior Leadership Orange Program. We must be able to reach your guidance counselor regarding acceptance into the program.



  • Have your parent read this portion and then both sign below:

    I am aware that my child is applying for the Junior Leadership Orange Program. If selected, I understand that we must be in attendance at a Family Informational Session that will be scheduled over the summer months (you will be given two dates and times to chose from.) In order to participate, my child will miss SEVEN days of school over the course of a year and any work missed while taking part in this program must be made up. This is a participatory program and youth are expected to be ACTIVE participants, taking part in conversations, interactive games etc…

    The Junior Leadership Orange Program is primarily funded through donations received from private donors, community groups and business leaders. While there is NO COST to participate in the program, we do ask the current JLO Class to participate in one annual fundraiser. Participation not only helps to raise additional funds, it also reinforces what an integral part the current class continues to play in the success of future Junior Leadership Orange classes.

    Any special needs, allergies or medical concerns must be communicated at the time of registration. If your child has special dietary needs, you must provide their own meals and snacks. If your child needs medication on hand during sessions, please provide that medication with a dated & signed Physician’s note. Provided medication will be secured in a locked box and transported with your child throughout the day for use as needed or designated. Note: Youth must be able to self-administer medication.

  • Please enter your full name
  • Date Format: MM slash DD slash YYYY
  • Please enter the applicant's full name
  • Date Format: MM slash DD slash YYYY