1st JESSE ROBREDO YOUTH LEADERS CAMP Feb 8-10, 2012 Camp Explore, Antipolo Empowering the Youth

for Good Governance Towards Nation Building Family Name Given Name Middle Initial

Home Address

Birthday School

Phone Number

Mobile Number Course and Year level

Email Address

Interests (You can choose more than one)

Arts & Culture Business & Finance Economic Development Education Environment Health Information Technology Infrastructure Internal Relations Media & Communications Politics & Government Rural Development & Agriculture Social Entrepreneurship Urban Development

ATTACHMENTS Updated Curriculum Vitae/Resume ( leadership experience, community involvement, awards & recognition) On a separate document, please answer the following questions: o o o What is your vision for the Philippines? (maximum of 100 words) What is Good Governance for you? (Maximum of 100 words) As a youth leader, how can you contribute to Good Governance? (Maximum of 150 words) Endorsement letter from school/organization

CERTIFICATION
I certify that the above information is complete, true and correct to the best of my knowledge and belief. I understand that any false statements will disqualify me from participation in the Jesse Robredo Youth Camp ___________________________
(Signature of Applicant)