Application for Child Leader Project at Norte Vista High School (CLP@NoVi) 2011-2012
Thank you for interest in CLP@NoVi 2011-2012.
To see this application online, please go here: https://docs.google.com/spreadsheet/viewform?hl=en_US&formkey=dDVIR2QzWHZ1bWI2Sjc0d1VVbmw0ZEE6MQ#gid=0 ; there will also be a link to this application through the CLP Norte Vista facebook group. Upon receiving your application, we will confirm with you regarding your CLP status via email or phone within one week. It is mandatory that all CLP@NoVi participants join the CLP Norte Vista FB ( you can do so by clicking on the following link http://www.facebook.com/groups/174506295896238/ or looking up the CLP Norte Vista Group). Also, your application is NOT COMPLETE until you submit the signed waiver of release and indemnity forms here. Please drop these off to Rosa Gutierrez.
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Full Name *
You may also provide your nick name.
Home Address *
Home Phone *
Mobile Phone *
If you do not have your own mobile phone, please write "0"
Email Address *
Please be careful when typing your address. Check for accuracy.
Do you currently have a passport? *
Question is being asked for possible trips across the border (e.g. Mexico)
Birthdate *
Format (MM/DD/YY)
Grade Level *
Emergency Contact Name *
Emergency Contact Number *
List your extracurricular activities and personal interest *
Include a minimum of 3
List Your Academic Strengths and Future Goals *
Make a List of Your Top 3
Who is your leader? What makes them a Leader? *
Answer the questions in a few sentences.
Name an Issue in YOUR community and how would you like to help solve it. *
Statement of Purpose *
A statement of purpose is a brief, focused essay about your goals with an organization. Please write 400 – 500 words (typed preferred) about why you wish to join CLP@NV and what you hope to accomplish as a member. Feel free to be creative and talk about other life interests and experiences that could add to the overall impact of CLP@NoVi. 
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