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YLA Reference Form

The student who sent you this link desires to participate in the Youth Leadership Academy of Madison County. We request each potential participant to provide a reference  as a part of the selection process.  This reference relates to the student’s character, ability, leadership potential and involvement in the overall community.  Your prompt attention in completing this form is greatly appreciated.  Complete all the information to the best of your ability.  Your reply is considered strictly confidential.  If you would prefer to talk with someone about this information, call 765-641-3863.
Check the appropriate box when comparing this student to his or her peer group: Attitude Towards School
Attendance
Cooperation
Dependability
Communication Skills
Flexible/Adapts
Initiative/Self Motivated
Integrity
Judgement/Common Sense
Maturity for his or her age
Complete this related to the student's involvement in his or her communities: Participation in Extracurricular Activities
Complete this related to the student's involvement in his or her communities: Leadership in Extracurricular Activities
Complete this related to the student's involvement in his or her communities: Participation in Civic Activities
Complete this related to the student's involvement in his or her communities: Leadership in Civic Activities
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