MLEEA 2023-2024 Minnesota Law Enforcement Exploring Youth Representative

Name

Phone

Address

Street Address Address Line 2 City ZIP Code

Fax

Date of Birth

(must be born before May 01, 2006)

Post No

Participating Organization

Learning for Life Office Name

Years in Exploring

Number of members in post

Past or present leadership position with post

School

Grade or class

GPA

Past or present school leadership positions

Past or present leadership positions with other youth organizations

e.g. Boy Scouts, Girl Scouts, Camp Fire, Church, Sports, YMCA, YWCA, 4H etc

I hereby recommend and approve this applicant for the position of Minnesota Law Enforcement Exploring youth representative.

Advisor’s signature

Advisor’s Telephone Number

Include a statement of 500 words or fewer outlining your qualifications for office, as well as what Law Enforcement Exploring has meant to you.

If needed, you can use a character counter here (opens in new window)

Alternatively, you can upload your statement below:

Max. file size: 128 MB.

References

List name, address, city, state, zip code, e-mail address, fax number, and number for each reference.

Post Advisor

School reference

Reference No. 1

Reference No. 2

Name of parent or guardian

Address

I hereby submit my name for consideration to serve as the 2023 – 2024 Minnesota Law Enforcement Exploring your representative and pledge that all information provided is true and accurate.

Signed

Date