Home Phone
Mobile Phone *
Parent/Guardian Home Phone
Parent/Guardian Mobile Phone *
Parent/Guardian Work Phone
Name of High School (Current) *
Grade *
Year of Graduation *
1: Employer Name
Position
Dates of Employment Month/Year
Contact Info Supervisor, Address, Phone
2: Employer Name
Position (copy)
Dates of Employment Month/Year
Contact Info Supervisor, Address, Phone
3: Employer Name
Position
Dates of Employment Month/Year
Contact Info Supervisor, Address, Phone
Rate your ability to use computers * Not at all Low Medium High
Course Name
School Name
Course Name
School Name
Internet * Not at all Low Medium High
E-mail * Not at all Low Medium High
Social Media (Facebook, Twitter, Instagram, etc.) * Not at all Low Medium High
Microsoft Office (MS Word, Excel, Access, etc.) * Not at all Low Medium High
Web Design (HTML, Dreamweaver, FrontPage) * Not at all Low Medium High
Digital Media (Music, Photography, Video) * Not at all Low Medium High
Graphics (Photoshop, Illustrator, etc.) * Not at all Low Medium High
Historical Research * Not at all Low Medium High
Public Speaking * Not at all Low Medium High
Social Media Influencer * Not at all Low Medium High
YouTube * Not at all Low Medium High
Blogs, Discussion Groups, Podcasting * Not at all Low Medium High
Please list anyother skills.
1. Describe a situation or experience where you have taken leadership initiative: *
2. As a leader, what are your strengths and challenges? *
3. Describe how reading and literacy are important to you. *
4. What does cultural awareness mean to you? *
5. What does social justice mean to you? *
5. What do you want to join L.A.A.W. Scholars? *
How Did You Hear About Us? *