Running and Winning Application

Running & Winning Application This interactive workshop is designed to give young women in high school and college the opportunity to explore public service as a career. Prospective participants should complete this online application form by Friday, October 19, 2007. Selection will be competitive with a total of 80 young women chosen to attend.

First Name:


Last Name


Street Address (Local):


City:


State:


Zip Code:


Phone Number (Local):


Email address:


School Name:


Year in school:
High School Senior
College First Year Student
College Sophomore

How did you hear about the Running and Winning Program?
Flyer    Web Site    Teacher/Administrator    Guidance Counselor    Friend    Email    Other   

If your answer above was "other," please list that source:


How important is politics in your life?
Highly Important
Important
Neutral
Unimportant
Highly Unimportant

How knowledgeable are you about local and state politics?
Excellent
Very Good
Good
Fair
Poor

How likely are you to get involved in politics in the future (e.g., working on a campaign, running for office, etc.)?
Highly Likely
Likely
Neutral
Unlikely
Highly Unlikely

Please list all community service activities in which you have participated:


In a short paragraph, please describe why you want to attend and what you hope to gain from participating in the Running and Winning program?


Do you have any accessibility needs?
Yes
No

If your answer to the question above was "yes," please indicate what accommodations you need.


Do you have any special dietary needs or restrictions?
Yes
No

If you answer to the question above was "yes," what are the needs or restrictions?