Youth Camp/Tour Application

Applicant Name

Home Email

Cell Phone

Mailing Address

Physical Address

City/Town

State/Province

ZIP/Postal Code

Date of Birth

Date of Birth: Month

Date of Birth: Day

Date of Birth: Year

Name of High School

Current Grade in School

Sophomore

Junior

Senior

Parent/Guardian

Parent/Guardian's Email Address

Name on Highline Account

If same as parent/Guardian, please skip.

Which trip is your first choice to attend?

Cooperative Youth Leadership Camp

Washington D.C. Youth Tour

Special activities in which you have participated:

What offices have you held in which organizations?

List honors you have received:

What are your hobbies, talents and special interests?

What are your future plans?

What are two benefits of being a member of an electric cooperative that you believe more people should know about? Explain why these benefits matter.

Essay: See prompt above. You may paste in the box below from your editor.

In 350 words, answer the essay question above. There is no right or wrong answer.

Letter of Reference

Attach one letter of reference from a teacher, counselor or employer.

One file only.
20 MB limit.
Allowed types: txt, pdf, doc, docx, ppt, pptx, odp, xls, xlsx, ods.