The program is geared toward high school sophomores & juniors only.

APPLICATION DUE DATE IS JULY 11, 2025

    YOUR PERSONAL INFORMATION:

    PARENT(S) (Or other adults to contact or keep informed):

    SCHOOL EXTRACURRICULAR ACTIVITIES (Please include what role you performed):

    COMMUNITY ACTIVITIES (Please include what role you performed):

    PERSONAL CHARACTERISTICS: Please rate yourself by circling the number you feel best represents you. 5 is the highest or very strong and 1 is the lowest or very weak.

    Ability to Communicate:

    Dedication:

    Service to the Community:

    Willingness to Learn:

    Open to New Ideas:

    Sense of Humor:

    Ability to Work with Others:

    Describe a time or event where you have shown leadership, teamwork or community service in your school,
    church, clubs, family, etc.

    How did you hear about YAC?

    Why are you interested in YAC?

    How much of a commitment can you make to YAC (meetings, activities, etc.)?

    What passions do you have for the issues in the area?

    If you had one word to describe yourself, what would that word be?

    Do you have any allergies, food or otherwise?

    Please tell us about a few of your favorites, so we can learn more about you:

    APPLICATION DUE DATE IS JULY 11, 2025

    If you have any questions about YAC or this application, please call 570-822-2065 or email info@luzfdn.org

    Thank you for your interest in the Youth Advisory Committee (YAC) of The Luzerne Foundation.