Participant First Name*

Participant Last Name*

Birthdate

Grade*

Street Address*

Town*

State Symbol ("MA" for Massachusetts)

Zip Code

Your School/Program

Your Phone # (only if you have one and your parents approve giving it to us)

In the format: "(###)-###-####"

Your Email Address (only if you have one and your parents approve of you giving it to us)

Email Address of your Parent or Guardian

Your Parent or Guardian phone # (if your parents approve giving it to us)

In the format: "(###)-###-####"

Are you by yourself or with a group?*

Have you ever filled out an application before?

Have you ever volunteered before (helped out with a service project at an organization, event, school, etc.)?

What are 3 things you would want to share about yourself (personality, interests, family, life experiences, etc.)?

What are some of your dreams for your future?

Do you see yourself as someone with gifts and abilities that could make the world better?

Do you think other people see the “real” you and appreciate your gifts?

Do you believe you are a good person?

Do you feel like you have the support you need to pursue your interests, passions and goals?

YOUR PROMISES TO US: I promise that all of the information I wrote on this application is true. Enter your first and last name as your signature, agreeing with these promises.*

How many minutes do you think this part of the application took you (just Part A)?