Successteam Youth Council Application – Successteam Connect

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Successteam Youth Council Application

Thank you for your interest in joining the Successteam Youth Council. This application helps us learn more about your goals, experiences, and how you align with Successteam’s mission and core values.

Please complete all sections carefully. Incomplete applications may not be considered.

Application Window: November 16 – February 16.

Applicants selected for the 2nd Round will be notified beginning January 2026.

Note: Your progress is saved in your browser, allowing you to return and complete the form later. Data is not submitted until you submit the form. For any issue, please email us at [email protected].

Student Information & Profile

First Name *

Last Name *

Date of Birth *

Age *

Gender *

Race/Ethnicity *

Hispanic or Latino

American Indian or Alaska Native

Asian

Black/African-American

Native Hawaiian or Other Pacific Islander

White

Two or More Races

Prefer not to answer

Biracial

Preferred Chapter Location *

CSRA Chapter (Aiken/Augusta/Edgefield)

Columbia, SC (Midlands/Richland/Lexington)

Shirt Size *

Current High School *

Current Grade Level *

Rising Grade Level *

(Grade You Will Be In Next School Year)

Current GPA

(if applicable)

Home Address *

Address Line 2

City *

State *

ZIP Code *

Phone Number *

Email Address *

Please refrain from using iCloud email address

List Any Extracurricular Activities That You Are Involved With

Examples: school, community, church, work.

What Most Interests You After High School? *

College

Career

Employment

Entrepreneurship

Essay Questions

Please answer each question in 150–250 words. Type or write clearly in the space provided or attach a separate document.

Why would you like to join Successteam Youth Council? *

What interests you most?

Describe a time when you helped someone, showed leadership, or took initiative. *

What did you learn from that experience about yourself?

As you think about high school, what are some goals or dreams you have for yourself? *

How could Successteam support you in reaching them?

If someone described you in (3) words, what would they say? *

and why?

Parent/Guardian Details

First Name *

Last Name *

Phone Number *

Email Address *

Relationship to Student *

Mother

Father

Grandparent

Annual Household Income *

Reflection Question: As a parent or guardian, what do you hope your student will gain from the Successteam Youth Council? *

Supporting Materials

Recommendation Letter *

This may be written by a teacher, counselor, coach, or community member. Maximum file size: 10 MB

Your Most Recent Report Card or Unofficial Transcript *

Accepted file types: doc, docx, pdf, jpeg, png, gif, odf. Maximum file size: 5 MB

Photo Release Consent *

By submitting this application, I grant permission for Successteam to use my student’s image or likeness for program materials and media purposes.

Acknowledgment & Signature *

By submitting this application, I affirm that the information provided is accurate to the best of my knowledge.

For any query please contact us now