SAN DIEGO YOUTH LEADERSHIP CONFERENCE

(Joseph H. Pendleton Youth Leadership Conference Inc.)PO Box 1494, Fallbrook CA 92088-1494

A PATRIOTIC EDUCATION PROGRAMOf

The Military Order of the World Wars

Date of Application _________________ Applicant Full Name: ___________________________________________ Age _____ Male _____ Female _____ LastFirstMIHome Address: ________________________________________________________________________________ StreetCityStateZipTelephone No: ( ) _________________Social Security No _____-_____-_____ Soph ___ Junior ___ Senior ___ Email Address: ____________________________________________ T-shirt Size: S M L XL XXL Name of Parent or Guardian: _____________________________________________________________________ Name and Address of Student's School: _____________________________________________________________ _____________________________________________________________ Session Applied for Session 1 (BSA Orange County Outdoor Education Center)(July 11 – 16)(

If traveling by means other than Auto and you expect someone to meet you at your destination, complete theFollowing

) I will arrive by ______________________ by _____________________ at ______________AM/PMairport, train stationplane, train by the following mode of transportation ___________________________________________________________ include flight or train information(Plan your trip to arrive at the conference not earlier than 1:00 PM nor later than 3:00 PM on Sunday of the first dayof the conference)I certify that this application is complete and that all information is true to the best of my knowledge (Incompleteapplications will be returned).Signature of Applicant: ______________________________________ Date: _____________________________

School or Sponsoring Organization Recommendation:

"I believe that this student possesses the qualifications to benefit from this leadership conference. The student possesses the academic qualifications as well as the motivation to become a leader and influence the actions of others for the benefit of our nation." Name of School/Sponsor Official: ______________________________________ Title: ______________________ Home Phone ( ) ____________________ Work Phone ( ) ____________________________ ext. _______ Note: Applications must be returned to the sponsoring organization in ample time to process and submit to theconference director by 17 June 2010. Funds are committed for housing, food services, and other logistic support andit is to allow sufficient time for processing applications, and the administrative and logistics details in preparationsfor the YLC. Applications will not be accepted or refunds made after the dates specified in the brochures.1