La Vida Center for Outdoor Education & Leadership
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ALP Application

Thank you for your interest in the Adirondack Leadership Program. Please fill out the application below to apply for the program. La Vida will contact you after we have received and reviewed your application. A $100 deposit is due after participants have been accepted into the program. Please make checks payable to "Gordon College" (we can no longer accept checks made out to "La Vida"—they will be returned). This form will timeout and erase answers after 30 minutes.


Adirondack Leadership Program Application

1. Name (last, first, middle initial)

2. Parent/Guardian Name

3. Street Address

4. City

5. State

6. Zip Code

7. Home Phone

8. Applicant's Cell Phone

9. Parent's Phone

10. Applicant's Email Address

11. Parent's Email Address

12. Please select the following:

Male
Female

13. Date of Birth

14. Age (at the time of ALP)

15. Current Year in School

16. T-shirt size

17. Height

18. ALP has a backpacking and a canoeing option. La Vida cannot guarantee, but will do its best to place participants in their trip of choice. Please indicate which trip you prefer.

Backpacking
Canoeing
I am flexible, either backpacking or canoeing.

19. Preferred Trip Dates:

Session 1: June 24-July 5
Session 2: July 8-July 19
Session 3: July 22-August 2

20. Why are you interested in the Adirondack Leadership Program?

21. Write a paragraph or more about a leader you want to be like and why.

22. What are two leadership qualities you hope to develop more during the ALP?

23. How did you hear about the Adirondack Leadership Program?

Mailing
Poster
Camp Fair
Attended camp before
Friend or family
Ad
Web
Other

24. Referred By (please list the person who told you about ALP):

25. Please list two people that we may contact as references to your leadership potential and character. Include their name, phone number and email address.

26. The above information is true and written by the applicant for the ALP.

Yes
No