College LAUNCH for Leadership

Student Information

Student Name:*

First

Last

Student's School:*

Student's Grade:*

Difficulty of student's academic program compared to that of other students:*

Intellectual capacity:*

Strength of character:*

Commitment to public service:*

Awareness of social justice issues:*

Impact he or she has made at school:*

Ability to interact with different groups:*

Additional comments:

Electronic signature:*

Date:*

Time:*

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Phone

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