Thanks for your interest in being a participant in our service learning Social Change Institute Project!

We are excited to be working with youth who want to help our community and world.

To apply to be an Service Learning participant please answer the following question

Please provide your first and last name

Contact information

(XXX)XXX-XXXX

(XXX)XXX-XXXX

Please provide your home address
Please answer the following questions briefly

Please keep your responses to under 60 words for each question.

Please provide the name and phone number for an adult who would recommend you for this institute.

(e.g. teacher, pastor, youth group leader, etc.)

Please include first and last name.

For example are they yourTeacher, Pastor, Youth Group Leader, etc.

(XXX)XXX-XXXX