Apply – Leadership Pinellas

Youth Leadership Pinellas is a series of interactive days designed to educate high school teens on community resources and issues, develop excellence in leadership, build teamwork skills, and foster involvement in community services.

If you would like to apply or sign up for the next information session please email [email protected] to be added to the list.

The Class of 2025 Application Season is Now Open

Youth Leadership Pinellas Application

1Contact Info

2Questionnaire

3References

4Applicant Commitment

Name*
First Last
School*
Graduation Year*
Home Address*
Street Address Address Line 2 City State ZIP Code
Date of Birth*
Month
Day
Year
Phone*
Your Email*

Tuition*
- No, financial assistance is not needed.
- Yes, my child qualifies for free/reduced lunch and would like to be considered for financial assistance.
Tuition for Youth Leadership Pinellas is $495 and is due in full by the September Parent Meeting. Financial assistance is available. If you would like for your child to be considered for assistance, please indicate that they qualify for free/reduced lunch program.
Parent/Guardian Permission
I am the parent/legal guardian of the student listed above. I have read the information and participation guidelines and am will to have my child participate if selected. Youth Leadership Pinellas, its agents and its employees have my full permission and consent to transport and otherwise provide transportation for my child by public service bus, private chartered bus, private automobile, or other means of transportation in connection with all sessions of Youth Leadership Pinellas during the school year in which he/she is a participant. Further, I understand that Youth Leadership Pinellas is a program run separate from any public or private school related program. The student is responsible for making up missed work and for getting the absences excused through school for all program days my child is away from school. I hereby release and hold harmless Youth Leadership Pinellas, Leadership Pinellas, its members, agents, employees or any individuals involved in the planning, organization or presentation of Youth Leadership Pinellas programming, for any accident, injury, illness or any damage whatsoever related to the above mentioned student's attendance at or participation in any activities or session of Youth Leadership Pinellas.
Parent/Guardian Signature*

Please type your full name.
Parent/Guardian Address*
Street Address Address Line 2 City State ZIP Code
Parent/Guardian Email*
Parent/Guardian Phone*

The Class of 2025 Application Season is Now Open

Youth Leadership Pinellas Application

Applicant Personal Commitment

Principles of Participation

Parent/Guardian Permission

Programs