New Leaders in Training Application

Applicant's Name*

(First) (Last)

DOB*

Month Day Year

Nickname

Gender*

Male Female

Grade Next Fall*

Address*

City*

State*

Zip*

Home Phone*

- Area Code Phone Number

Cell

- Area Code Phone Number

E-mail*

School*

Do you have any special needs that could affect your participation in the LIT program?*

Do you take any medication that may need to be administered during camp hours?**

Do you have any notable allergies we should be aware of during your time at camp?

What is your T-Shirt size?*

Youth Large Adult Small Adult Medium Adult Large Adult XL

Parent/Guardian's Name*

(First) (Last)

E-mail*

Cell Phone*

- Area Code Phone Number

Home Phone *

- Area Code Phone Number

Work Phone

- Area Code Phone Number

Parent/Guardian's Name

(First) (Last)

E-mail

Cell Phone

- Area Code Phone Number

Home Phone

- Area Code Phone Number

Work Phone

- Area Code Phone Number

Contact Name*

(First) (Last)

Relationship*

E-mail*

Cell Phone*

- Area Code Phone Number

Home Phone*

- Area Code Phone Number

Other

- Area Code Phone Number

Upon acceptance into the LIT Program, I agree to attend the following mandatory training in my area: *

Southern California: Saturday, May 18th, 2024 [10:00 am - 3:00 pm] Northern California: Sunday, June 2nd, 2024 [10:00 am - 3:00 pm] Long Island, New York: Saturday, June 15th, 2024 [10:00 am - 3:00 pm] Washington State: Tuesday, June 25th, 2024 [10:00 am - 3:00 pm] Texas: Tuesday, June 4th, 2024 [10:00 am - 3:00 pm]

I would like to be assigned to the following location:*

If the above location is no longer available, this is my second choice*

Date* (Week 1)

Date* (Week 2)

Date (Week 3)

Date (Week 4)

Date (Week 5)

Date (Week 6)

Have you ever attended a Destination Science camp in the past? *

Yes No

When?

Where?

How did you hear about the LIT program? *

What camp experience do you have, either attending or volunteering? *

What leadership experience do you have? *

What experience do you have working with elementary age children? *

Why would you like to be a Leaders In Training (LIT) with Destination Science? *

What are your expectations of the LIT Program & being an LIT this summer? *

What new skills do you hope to gain from being a LIT? What expectations do you have? *

Applicant's Name:*

Application Date*

- Month - Day Year

Parent/Guardian's Name*

Signature Date*

- Month - Day Year

New LIT Application

LEADERS IN TRAINING

2024 Application for New LIT

LIT Information

Parent/Guardian Information

Mandatory Training

Camp Location & Schedule

About Me

7 Key Expectations of Every LIT:

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