2015 CYCLE Contest Application Cooperative Youth Conference & Leadership Experience, July 15-17, 2015, Jefferson City sponsored by: Name: ___________________________________ School: __________________________________ Address: ________________________________ City: ____________________ Zip: _____________ Home Telephone: __________________________ Cell Phone: ______________________________ Email Address: ____________________________________________________________________ Parent/Guardian Names: _____________________________________________________________ Are you employed? If so, where?_____________________________ High School GPA: __________ High school teacher or counselor responsible for student sign-up: _____________________________ I certify that this information is true, complete and accurate. I authorize release of information to confirm and/or verify this application. I further authorize release of my name in connection with announcements of CYCLE awards in the event that I am selected to be a Boone Electric Cooperative CYCLE delegate. I grant Boone Electric Cooperative and the Association of Missouri Electric Cooperatives permission to take my photograph during the Youth Tour banquet and trip to Jefferson City, and understand that these photographs may appear in marketing pieces to promote future CYCLE programs. __________________________________________________________________ Applicant’s signature and date Parent/Guardian signature and date Application Deadline: Friday, March 6, 2015 Mail or hand deliver application to: BEC CYCLE Contest, 1413 Rangeline St., P.O. Box 797, Columbia, MO 65205, or email applications to [email protected]. Questions? Please contact the Boone Electric Cooperative Communications Team at 573-449-4181 or email [email protected]. 2015 CYCLE Contest Application Cooperative Youth Conference & Leadership Experience, July 5-17, 2015, Jefferson City sponsored by: (Please note: You may attach a separate piece of paper if you need more space to answer the questions below.) What have you done in your lifetime that gives you the greatest sense of accomplishment or satisfaction? Please give details: __________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Judge’s Score: (1-10): __________________________________________________________________________________________ List activities with school, community and other organizations: ______________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Judge’s Score: (1-10): __________________________________________________________________________________________ List any achievements or awards received: _______________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Judge’s Score: (1-10): __________________________________________________________________________________________ __________________________________________________________________________________________ List anything else you consider important about yourself concerning application for CYCLE: __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Judge’s Score: (1-10): __________________________________________________________________________________________ Please attach the following to your application: 1. A paragraph stating why you would like to be chosen to represent Boone Electric Cooperative at the CYCLE conference. 2. Explain, in your own words, what is an electric cooperative? 3. Letter of recommendation from a teacher, coach or youth organization leader. Applications will be reviewed by the Boone Electric Cooperative CYCLE committee. Up to six CYCLE delegates will be selected based on their community service, scholastic achievements and leadership experiences. CYCLE delegates will be notified no later than Friday, March 20, 2015. CYCLE winners are recognized at the Youth Tour finals competition at Boone Electric Cooperative headquarters in Columbia the evening of Thursday, April 9, 2015. Selection will be made without regard to the applicant’s race, color, ethnicity, religion, gender or physical handicap.