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Class of 2021-22
Centennial*, Chattahoochee, Johns Creek, Northview RISING
SOPHOMORES and JUNIORS*do not have to be Johns Creek resident
Our Mission and Vision:The Student Leadership Johns Creek (SLJC)
Program equips students with chances to acquire and implement
leadership skills in their school and community. The mission of
SLJC is to foster the development of student leadership skills
through various experiences. .
CALENDAR Application Deadline
January 31, 2021
Team Building Retreat August, 2021
September Session September 14, 2021
October Session October 12, 2021
November Session November, 2021
January Session January 11, 2022
February Session February 10, 2022
March Session March, 2022
Graduation/End of Year Celebration
April, 2022- TBA
*dates subject to change
Our Goals: Identify high school students who are leaders or have
demonstrated leadership
potential. Give young people the knowledge, tools, and contacts
to shape successful
leaders. Instill and nurture a sense of social responsibility in
our youth. Offer a forum for young leaders to express their needs,
goals, and opinions. Explore the diverse facets of Johns Creek,
Fulton County, and Georgia’s social
affairs, government, and business. Provide participants a chance
to serve their community. Present young leaders with a renewing and
fun experience.
Monthly Sessions Include:
- Leadership Topics and Training- County and State Government-
Resume Building and Interview Skills- City Management and
Governance- Working as a Team- Project Management- Portfolio
Building- Shadowing Business Professionals- Community Service-
Effective Communication
Completed applications must be returned to your school sponsor
by January 31, 2021. School sponsors listed below:
- Centennial: Daniel Blanchard - Chattahoochee: Amanda Wile-
Johns Creek: Roya Schweinbeck - Northview: Christie Bounds
Questions - Email: Irene Sanders -
[email protected]
Download file and print with your name as title when complete.
Submit printed form to School Sponsor.Innovation Academy*,
- Innovation Academy: TBD (send applications to Mrs. Sanders -
email below)
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Class of 2021-22
I understand that I must complete the Applicant’s submittal
portion of this by myself, and state that no one else has completed
the application on my behalf.
Signature of Applicant:
Signature of Parent/Guardian:
APPLICATION CHECKLIST
Please type or print. Only completed applications will be
considered, and must include: 1. Applicant’s Submittal. Fill out
completely2. A recommendation from your principal, counselor, or a
current teacher who knows your capabilities best.
Recommendations SHOULD be submitted in sealed envelope as part
of application or can be submittedat this link:
https://forms.gle/4XpbcyR7igashC1w8
REQUIREMENTS OF THE PROGRAM
One hundred percent (100%) attendance is required of each
student. I have compared my schedule with the Program Calendar
dates attached. If I am selected, I commit to attend every one of
the program sessions.
If I am selected, I agree that I will wear casual business
attire to each of the activities unless informed otherwise, out of
respect for the professional establishments we will be
visiting.
I further understand that e-mail will be the primary method of
communication between the program leaders and the participants. If
I am selected, I will have an active e-mail account that I will
check daily for communication about the program.
A $500 tuition fee is required to cover materials, program
expenses, and the retreat payable in two annual payments: $350 upon
acceptance into the program and $150 by May 1, 2021. The tuition
fee is to be made payable to Student Leadership Johns Creek.
By signing (or typing name) below, I am stating that I have read
the above REQUIREMENTS OF THE PROGRAM and agree to the REQUIREMENTS
OF THE PROGRAM 100%.
YES NO
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Class of 2021-22
Full Name
Email Address Sex:
Home Address
City Zip
Name you prefer to be called
School: Current Grade:
Cell Phone:
Birth date:
Current GPA:
Parent/Guardian Name:
Parent/Guardian Cell Phone:
Signature of Principal/School Sponsor:
Do you feel that you will have the time to take on the necessary
time commitment of this program?
PERSONAL INFORMATION (Please print legibly)
M F
Y N
Many activities including debate, robotics, sports, Move on When
Ready and Dual Enrollment challenge student’s ability to
participate in programs such as Student Leadership Johns Creek.
Y N
Discipline Violations, if yes describe
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Class of 2021-22
Organization/Activity Grade in School Leadership Responsibility
or Involvement
If you have a job, where?
How many hours a week do you work?
If selected, would your employer allow time off, if
necessary?
Choice 1: Choice 2:
MENTORING / SHADOWING
During the program you will be asked to shadow a person in a
profession you are interested in for 4-6 hours. List two
professions that you might be interested in shadowing:
ORGANIZATIONS AND ACTIVITIES
Please list in order of importance to you, up to three school,
volunteer, social, athletic, artistic or other activities or groups
in which you have participated during the last four years:
WORK AND VOLUNTEER EXPERIENCE
Please list any job experience you have had, paid or volunteer,
and briefly tell us more about it:
Yes No
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Class of 2021-22
1. Why are you interested in Student Leadership Johns Creek?
2. Why should we pick you to participate in the two-year
program? Include qualities about yourself that make you a good
candidate for SLJC.
3. What do you see as your most impactful strength as a student
and group member?
APPLICATION QUESTIONS: no more than 50 words per answer.
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Class of 2021-22
4. How could you see using that particular strength while a
member of SLJC?
5. What do your teachers compliment you about and why?
6. How could you add value to your school by being a member of
SLJC?
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Class of 2021-22
7. What is the single biggest challenge facing student-leaders
today?
8. How would you engage others to address this challenge as a
student leader?
9. Name a person who has had a tremendous impact on you and
describe why and how this person impacted your life?
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Class of 2021-22
10. Explain a situation in which you inspired another
person?
11. Share one experience about yourself that you would like us
to know in our selection process?
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Class of 2021-22
I am providing a reference for the following student who I
recommend for participation in SLJC.
Your Name: Title:
School:
Email Address: Cell:
What unfulfilled potential leadership skills do you see in this
applicant?
What are the first three (3) words that come to mind that
describe the applicant?
Additional comments you may want to provide: (optional)
Signature: Date:
undefined_3: OffSex: OffY: OffN: OffN_2: OffY_2: Offundefined_7:
OffTitle: What unfulfilled potential leadership skills do you see
in this applicantRow1: What are the first three 3 words that come
to mind that describe the applicantRow1: What are the first three 3
words that come to mind that describe the applicantRow2: What are
the first three 3 words that come to mind that describe the
applicantRow3: Additional comments you may want to provide
optionalRow1: Full Name: Home Address: City: Zip Code: Preferred
Name: School: Current Grade: Birthdate: Text11: Discipline
Violations: Parent/Guardian Name: Parent/Guardian Cell Phone:
Choice 1: Choice 2: Job Experience: Job Information: Hours:
Question 2: Question 3: Question 4: Question 5: Question 6:
Question 7: Question 8: Question 9: Question 10: Question 1:
Question 11: Student Name: Student Email Address: Student Cell
Phone: Principal / School Sponsor Signature_es_:signatureblock:
Parent/Guardian Signature_es_:signatureblock: Applicant
Signature_es_:signatureblock: Grade in School Line 1: Leadership
Responsibility Line 1: Organization/Activity Line 1:
Organization/Activity Line 2: Grade in School Line 2: Leadership
Responsibility Line 2: Organization/Activity Line 3: Grade in
School Line 3: Leadership Responsibility Line 3: Reference Name:
Reference School: Reference Email Address: Reference Cell Phone:
Reference Signature_es_:signatureblock: Reference Date:
