Application Form | Wendell H. Ford Government Education Center

Applying for

I am applying for:

General Information

Name*

First Middle Last

Preferred Name

Address*

Street Address City State ZIP Code

Parent\Guardian Name*

First Last

Phone*

Parent Email*

School Name*

Counselor Name

First Last

Student Email*

Student Phone*

Extracurricular Activities, Special Awards, Honors

Please explain why you would like to continue to be involved in the Wendell H. Ford Statesmanship Academy

EmergeNext Essay Question (Please attach your response) In your opinion, what are two pressing problems in the Owensboro area today and how can the principles of cooperation, civility and compromise be used to resolve those problems? ***Please be sure to click the "Upload" button after choosing your file for your essay.***

Sophomore Essay Question (Please attach response: 250 minimum-maximum 500 words) Please write an essay in support of how cooperation, civility, and compromise enhance ones leadership potential. Use one or more real life experiences to illustrate that you possess the character traits identified. ***Please be sure to click the "Upload" button after choosing your file for your essay.***

Junior Essay Question (Please attach response: 250 minimum-maximum 500 words) In your own words, please define the Three C's and tell us what they mean to you. ***Please be sure to click the "Upload" button after choosing your file for your essay.***

Senior Essay Question (Please attach response: 250 minimum-maximum 500 words) Please explain how you are spreading the Ford Center mission of cooperation, civility, and compromise independently in your own life. ***Please be sure to click the "Upload" button after choosing your file for your essay.***

Media permission*

I hereby give my permission for my child’s photograph as a participant in Wendell H. Ford Government Education Center programs to be used in publications of or articles about the Wendell H. Ford Government Education Center.

Consent*

I agree.

NOTE: I certify that I have read and understand the above and that the information given on this form is accurate. By selecting “YES” I understand that it is a signature of approval.