Parent/Guardian Permission Form

{{ylk_logo}} PARENT/GUARDIAN PERMISSION FORM

Deadline: {{reference_last_date}}

WHAT IS YOUTH LEADERSHIP KNOXVILLE?

Since 2014, Youth Leadership Knoxville has given area high school juniors the opportunity to enhance their knowledge of Knoxville and develop servant leadership skills. Designed to inspire and encourage youth to become effective leaders in their school and our community, students also form new friendships with students across Knox County. This 10-month program features team building skills and curriculum relevant to teens, providing opportunities to meet and engage with civic and community leaders, including government officials and  business leaders. Tuition is $150. A limited number of scholarships are available. Students are required to enroll in HUM 2100: Leadership Development at Pellissippi State Community College. This course is taught by a college professor and allows for a more formal exploration of leadership and the opportunity to earn 3 hours college credit. There is no additional cost associated with the course. Participation is limited to rising high school juniors and the application deadline is {{student_last_date}}.

SELECTION PROCESS

Approximately 50 diverse students representing all Knox County High Schools including public, private and homeschool students are selected each year. The following documentation must be completed and submitted by the {{student_last_date}}. Late applications will not be considered.

1. Student Application submitted online by the student. (Deadline: {{student_last_date}})
2. Parent/Guardian Permission Form submitted online by Parent/Guardian.(Deadline: {{reference_last_date}})
3. Community Reference Form submitted online by personal reference.(Deadline: {{reference_last_date}})
4. Principal Permission Form submitted online by principal.(Deadline: {{reference_last_date}})

If you have any questions regarding the application process, please contact Samantha Lacy at slacy@leadknox.com or (865) 246-2601.

PARENT/GUARDIAN PERMISSION

If selected, I understand that my son/daughter is a representative of {{automate_high_school}}. If accepted, my son/daughter has permission to participate in Youth Leadership Knoxville. I understand this includes a week long summer camp from 9 a.m. to 2 p.m. the week of July 8^th – July 12^th, 2024, and the following program days:

Class of 2024-2025 Program Schedule

*Session dates and times are subject to change. Attendance at Summer Camp on Monday, July 8 is mandatory, and students must attend 4 of the 5 summer sessions. Students must be present for 7 of the 9 non-summer camp sessions in order to graduate. If the student is unavailable to attend the Orientation, a parent/guardian or adult family representative must attend. {{control_checkbox_legal_guardian}} I am the parent/legal guardian of {{automate_student_name}}. I have read the information regarding the Youth Leadership Knoxville Program and am willing to have my child participate if selected. {{control_checkbox_mandatory_orientation}} I understand, that in order to graduate from the program, my son/daughter must be present for the mandatory Orientation (with parent/guardian) and attend 4 of the 5 summer camp session days (Monday is mandatory) and 7 of the 9 monthly sessions. TUITION AND FINANCIAL ASSISTANCE {{control_checkbox_non_refundable_tuition}} If selected, my son/daughter will be billed for the non-refundable tuition of $150, which is payable in full by May 24^th, 2024. Youth Leadership Knoxville has financial assistance available to those who demonstrate a need. Please note: The Selection Committee will not be made aware of any financial assistance requests. Leadership Knoxville may request that the student make a personal commitment and either monetary and or service hours with our organization. Should your student qualify for scholarship, a $25 fee will be required to participate. {{control_checkbox_financial_assistance}} My son/daughter requires financial assistance to participate in the program. Please tell us why you are requesting financial assistance: {{comment_box_financial_assistance}} By completing the following information you are providing your electronic signature and approval granting your son/daughter’s permission to participate in the program if selected. {{marital_status}}{{parent_full_name}} {{control_relationship_to_student}} {{parent_phone}} {{parent_email}} Address: {{parent_address}}   {{submit_button}}   If you have questions or want additional information please contact Samantha Lacy at slacy@leadknox.com or (865) 246-2601.