NEXGEN Form

Applicant Information
Name*
First Last
Gender
Preferred Pronouns

He/him

She/her

They/them

Prefer not to answer
Preferred Name*
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What High School Do You Attend?*
Home Address*
Street Address City State ZIP Code
Email Address*
Cell Phone*
Upload a Headshot*
Max. file size: 50 MB.
Please be sure your file name is YOUR name
T-Shirt Size*
Dietary Restrictions*
Parent/Guardian Information
Parent/Guardian Name*
Parent/Guardian Email Address*
Parent/Guardian Phone Number*
Has your parent/guardian been involved in LSI Programming before?*
Describe your work/volunteer experience and any organizations that you belong to.*
What special abilities/skills will you bring to the NEXGEN Program?*
What is your definition of success?*
What are your professional expectations and/or goals?*
What is your personal definition of a leader?*
If you could improve one thing in your community or school, what would it be and why?*
What are your expectations for this program?*

Leadership Southern Indiana