Required Forms

All students and their parents or guardians are required to submit the forms below within 60 days after registration or immediately if your program is less than 60 days away. The waiver forms are required by our partners for team building and service project activities to ensure your student can participate in the activity.

 

Leadership Summit at Harvard University (all sessions)

[  ]  Health and Medical Form - A complete copy of student’s immunization record is required. Notify the program office if health conditions change before travel.

[  ]  Student Success Contract

[  ]  Team Building Waiver - Hale Reservation

[  ]  Harvard University Waiver

[  ]  Service Project Waiver - United Way

[  ]  Recommendation Form(s) - Two recommendations are required for all students. For nominated students, the nomination itself counts as one recommendation. Nominated students must provide one recommendation form. Students who enroll but are not nominated must provide two recommendation forms. Print/download and give the form(s) to a teacher, coach or community leader to complete. Return completed form(s) to the Program Office.

 

LEADERSHIP SUMMIT AT UCLA

[  ]  Health and Medical Form - A complete copy of student’s immunization record is required. Notify the program office if health conditions change before travel.

[  ]  Student Success Contract

[  ]  Team Building Waiver - Fulcrum

[  ]  Service Project Waiver - United Way

[  ]  Recommendation Form(s) - Two recommendations are required for all students. For nominated students, the nomination itself counts as one recommendation. Nominated students must provide one recommendation form. Students who enroll but are not nominated must provide two recommendation forms. Print/download and give the form(s) to a teacher, coach or community leader to complete. Return completed form(s) to the Program Office.

 

LEADERSHIP SUMMIT AT yale university

[  ]  Health and Medical Form - A complete copy of student’s immunization record is required. Notify the program office if health conditions change before travel.

[  ]  Student Success Contract

[  ]  Team Building Waiver - Pine Lake Challenge Course

[  ]  Service Project Waiver - United Way

[  ]  State of CT Transportation Notice

[  ]  Recommendation Form(s) - Two recommendations are required for all students. For nominated students, the nomination itself counts as one recommendation. Nominated students must provide one recommendation form. Students who enroll but are not nominated must provide two recommendation forms. Print/download and give the form(s) to a teacher, coach or community leader to complete. Return completed form(s) to the Program Office.

 

Medicine & health care SUMMIT AT johns hopkins university

[  ]  Health and Medical Form - A complete copy of student’s immunization record is required. Notify the program office if health conditions change before travel.

[  ]  Student Success Contract

[  ]  Team Building Waiver - Go Adventures

[ ] Service Project Waiver - United Way

[  ]  Activity Waiver - University of Maryland Shock Trauma Center

[  ]  Photo Release - JHU Simulation Lab

[  ]  Recommendation Form(s) - Two recommendations are required for all students. For nominated students, the nomination itself counts as one recommendation. Nominated students must provide one recommendation form. Students who enroll but are not nominated must provide two recommendation forms. Print/download and give the form(s) to a teacher, coach or community leader to complete. Return completed form(s) to the Program Office.

Optional Forms

[  ]  Travel Protection Plan Enrollment Form

[  ]  Transportation Deviation Form (if pick up/drop off is requested from locations other than the designated airport)

[ ] Scholarship Application (Must be received by the Program Office with supporting documentation by February 15, 2019. See additional details.)