First Name:

Last Name:

Email:

Phone:

Address:

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State:
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Zip:

Gender
Male
Female

Work/Cell Phone

School/Community Name

What Position Are You Applying For?
Youth Staff (Finishing grades 10-12)
I-Team (Age 18-20)
Adult Staff (Age 21 and Up)

Grade in 2010-2011 School Year
11th
12th
College Freshman
College Sophomore
College Junior
College Senior
Adult

Emergency Contact Name

Emergency Contact Phone

Do you have an IDFY Chapter at your school or in your community?
Yes
No

If yes, describe your involvement with the IDFY Chapter.

What have you done to promote tobacco, alcohol, and drug prevention in your school or community?

Describe your experience with youth programs, events, or conferences.

Describe your experience facilitating small groups.

Describe your experience leading games or activities.

Write a 100-word statement, describing your personal committment to being substance-free.

No staff or participant at the Idaho Youth Summit is allowed to use tobacco, alcohol, or illegal drugs. Anyone who has these substances in their possession or uses them at camp will be sent home immediately. Are you willing to abide by this rule?
Yes
No

Thank You for applying for staff. *Please disregard payment request on the Confirmation Page of this application. Your application will be complete once we recieve your Recommendation Letters. Additional comments regarding your application:

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