Justice Leadership Club – Center for Youth and Family Advocacy

The JLC is where students put justice into practice. You create restorative communities and lead projects that tackle real challenges in schools, neighborhoods, and beyond. JLC is about young people shaping a fair, connected, and just world. Your work will show that youth are not just standing on the sidelines waiting for change to happen. You are the architects of change. You are the movement.

Join the Justice Leadership Club

"*" indicates required fields

STUDENT INFORMATION

Name*

First Last

Name you prefer to be called*

Phonetic pronunciation of your name*

Preferred pronouns*

Date of Birth (mm/dd/yyyy)*

Ethnicity

Grade

Please enter a number from 1 to 12.

School Name

Email*

Phone*

Home Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

PARENT/GUARDIAN INFORMATION

Parent/Guardian Name*

First Last

Relationship to student*

Parent/Guardian Email*

Address (if different from the student)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

PERSONAL INTEREST STATEMENTS

The following statements must be completed by the student.

How did you hear about the Justice Leadership Club?*

Why are you interested in joining? (100 word maximum)*

What is the most important thing you would like to share about yourself? (100 word maximum)*

EMERGENCY CONTACT INFORMATION

Emergency contact name*

First Last

Emergency Contact Phone*

AGREEMENTS & WAIVERS

Student Signature*

Parent/ Guardian Signature*