Youth to Washington Contest

Personal information

First Name

Last Name

Address

City

State

Zip Code

Date of Birth

Phone Number

Email Address

First Name

Last Name

Parent Phone Number

Parent Email

JCE Co-op

Electric

Natural Gas

Broadband (Fiber)

High School Attended

Grade

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Personal Achievement

Organizations and Activities

Organizations and Activities
	Organizations and Activities	Item weight

more items

Please include number of years of involvement

Volunteer Work and Activities

Volunteer Work and Activities
	Volunteer Work and Activities	Item weight

more items

Please inculde number of years

Work Experience

Work Experience
	Work Experience	Item weight

more items

Please include number of years

Special Awards and Recognitions

Special Awards and Recognitions
	Special Awards and Recognitions	Item weight

more items

Please include both school and nonschool activities; please include number of years of involvement

Short Answer Essays

What are your plans after high school?

What moment in American history do you wish you had been a part of and what would you have contributed?

Cooperatives can provide any needed service such as electric, telephone, water, food, insurance, etc. Explain a benefit of being a cooperative member.

Why are you applying for the Youth Tour Program?

If you win the Youth to Washington Program, you may be asked to help promote the program to fellow classmates next year. Explain one way you would promote the program and be creative.

Statement of Applicant and Parent or Guardian

Date:

Student Signature:

Date:

Parent/Guardian Signature:

We have examined this application, including accompanying submissions, and to the best of our knowledge and belief, it is true, corrent and complete.