Welcome to the Wildlife Leadership Academy
Conservation Ambassador Application!  

Once you have submitted your preliminary application, it will be reviewed for initial approval, and, if eligible, you will be invited to submit an essay upon which final acceptance will be decided.
Begin Application
 
What's your first name? *

 
What's your last name? *

 
What is the first name you'd like us to use? *

This is the name we'll put on your nametag, if accepted.
 
If applicable, who nominated you to apply to the Academy?

 
Full name:

 
Occupation:

 
If you were not nominated, please list the contact information for a reference (an adult who knows you well, but is not a relative).

Example of acceptable references: Employer, teacher, youth group leader, coach, etc.
 
Full Name:

 
Occupation:

 
Phone Number:

 
Email:

 
Nice to meet you!  What are your parent(s)/guardian(s) name(s) (first and last)? *

We'll need their permission for you to attend field school.
 
Please fill in your permanent address.

 
Address: *

 
City *

 
State *

 
Zip Code: *

 
What PA county do you reside in? *

If applying from another state, please indicate your county as well.
 
Please indicate the Primary phone number at which to reach your PARENT/GUARDIAN:

 
Primary Number (XXX) XXX-XXXX *

 
Is this a cell phone number? *

     
 
Whose phone number is this - mother, father, applicant? *

 
What is the best time to call this number? *

 
Please indicate a secondary number you/your parent or guardian can be reached at:

 
Secondary Number (XXX) XXX-XXXX *

 
Is this a cell phone number? *

     
 
Whose phone number is this - mother, father, applicant? *

 
What is the best time to call this number? *

 
Where do you live (check one)? *


 
How old are you? *

 
What is your birthdate? *

Please use month/date/year format. (example: 01/25/1993)
 
Please Indicate your gender. *


 
What is your t-shirt size? *


 
What is your current GPA?

If you are homeschooled or do not have a traditional GPA, please indicate such in the box below.
 
What grade are you entering in the 2017-18 school year? *


 
What is the name of the middle/high school you currently attend? *

 
What is your expected year of graduation from high school? *

 
What is the name of your local newspaper?

 
How did you hear about the Wildlife Leadership Academy?


 
If referred by a current/former student, please indicate their full name:

 
The Wildlife Leadership Academy offers six field school options for the summer of 2017:

PA Bucktails (white tail deer focus) June 13-17 in Huntingdon County (at Stone Valley Recreation Area)

PA Bass (bass focus) June 27-July 1 in southern Lancaster County (at Camp Oak Hill)

PA Brookies (brook trout focus) July 18-22 in Clinton County (Sieg Conference Center)

PA Drummers (Ruffed grouse focus) July 18-22 in Huntingdon County (at Stone Valley Recreation Area)

PA Gobblers (turkey focused) July 25-29 in Huntingdon County (at Stone Valley Recreation Area)  ***NEW for 2017***

PA Ursids (black bear focus) August 1-5 in Huntingdon County (Stone Valley Recreation Area)


 
PLEASE RANK YOUR FIELD SCHOOL PREFERENCE

1 being your TOP CHOICE, 5 being your LAST CHOICE
 
PA Bucktails (white tail deer)
June 13-17 
Huntingdon County

 
PA Bass (bass focus)
June 27- July 1
southern Lancaster County


 
PA Brookies (brook trout)
July 18-22
Clinton County

 
PA Drummers (Ruffed grouse)
July 18-22
Huntingdon County

 
PA Gobblers (turkey focus)
July 25-29
Huntingdon County

 
PA Ursids (black bear)
August 1-5
Huntingdon County

 
Please list any academic achievements or activities (e.g. honor roll, envirothon team) *

 
Please list any non-academic extracurricular achievements or activities (e.g. community service, 4-H, athletics, clubs) *

Thanks for filling out our application {{answer_30202140}}!

Now that you have completed the preliminary application, it will be reviewed, and, if eligible, you will be invited to submit an essay upon which final acceptance will be decided.
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