NOMINATION FORM

i. ABOUT LYLP:
The Life Youth Leadership Program (LYLP) of Lifebank Foundation (LBF) is a community-based project that aims
to develop the character, knowledge, skills, and understanding of the poor and disadvantaged youth needing
to become effective leaders, in their home, in their community and in their workplace.

The Life Youth Leadership Program runs three main activities for young leaders: Leadership Training, Induction as
Life Youth Associates, and Project implementation.

The potential youth leaders will receive training on leadership and will be encouraged to become leaders in
their local communities as an avenue for them to demonstrate their ability to strategize, organize and
implement a collective community service that will benefit underprivileged children and youth and other
marginalized individuals or groups in their community.

ii. ELIGIBILITY REQUIREMENTS:

Interested youth leader applicants must be:

1. Currently an LBF scholar. 5. Willing to dedicate time & participation.

2. At least 17 to 25 years old.
3. Physically fit.
4. Very interested to join the program.
6. Able to complete all required activities.
7. Able to submit all requirements document.
8. Committed to serve as a Children & Youth Welfare &
Rights in their respective communities.

III. PERSONAL INFORMATION

Please write legibly.

PERSONAL DATA
Last Name: First Name: Middle Name: Ext:

Date of Birth (mm/dd/yyyy): Age:

Sex Male Female

Address:

Barangay Municipality/City Province Region

LBF Unit Name & Number:(get this info from your parents) Email:

Contact Number Smart/Sun/TnT: Globe/TM:

EDUCATIONAL BACKGROUND
Elementary: Year Graduated:
Secondary: Year Graduated:
Course: Year Level:
Special Award/s:

MEMBERSHIP/COMMUNITY/SCHOOL AND VOLUNTARY INVOLVEMENT

CHARACTER REFERENCE/S:
Name Contact Details
1.

2.

3.
IV. WE WANT TO KNOW MORE ABOUT YOU:

1. Please tell us a little about yourself (e.g. Interests, hobbies).

2. Have you ever volunteered before? Yes No

If yes, please provide more information:

3. Please tell us why you want to be part of the Youth Leadership Program of LifeBank Foundation?

4. What are your top 3 advocacy?

(Please put number 1, 2, 3 according to your priority)

Poverty and Hunger Environment and Agriculture

Health and Well-being Marine Life Preservation
Education Climate Action
Water and Sanitation Peace and Justice
Sustainable Energy Communication and Media
Employment and Economic Growth Gender and Equality
Religious/ Faith-based Others:
V. EXPECTATIONS:
Kindly check the box/Es that applies to you the most.

What do you expect to learn?

 Understanding good leadership behaviors Enhancing commitment to active citizenship & social responsibility
 Polishing interpersonal and communication skills Identifying a leadership style and values
 Empowering, motivating , and inspiring others Developing the ability to strategize and organize
Developing self-confidence Acknowledging individuality
Demonstrating teamwork Making meaning of service experiences
Understanding various ways to contribute to social change Identifying personal values
Developing a commitment to service Others:
Methodology
Lecture Role Playing
Demonstration Group Activities
Simulation Multimedia Learning
Structured Learning Experience Community Immersion
Open Space Team Building Activities
Story Telling Others:
Facilitator
Knowledgeable about the topic/s Walks the talk
Jolly and with a sense of humor Able to sustain the attention of the audience
Has a rapport with the audience Approachable and fun
Able to deliver ideas clearly Others:

VI. COMMITMENTS:

I will commit to:

 The Youth Leadership Program of LifeBank Foundation;
 Actively participate in meetings, consultations, trainings, and all required activities of the Youth
Leadership Program, to the best of my abilities;
 Challenge myself for development and learn new skills in leadership and self-development;
 Respect other group members and my fellow youth in the community;
 Be a responsible Youth Leader in the community;
 Initiate, develop, and implement worthwhile Project/s for the community; and
 Enjoy my time and have fun.

I (name) ________________________________________ declare under oath that this form has been duly
accomplished by me; I certify that all information provided are true and correct; Further, by signing
this document, I confirm my intention of applying to the LifeBank Youth Leadership Program.

Signed:________________________________ Date:______/______/_______

For further information, you may contact our Youth Coordinator at 0999-652-7662.

Kindly submit a scanned copy of this form to any of the LBF Youth Leadership Team portals:
 FB Page : LBF YOUTH Leadership
 Email Address : ssddcamp@gmail.com

Please note:
 Nominees will be contacted regarding the status of their application.
 A parental / guardian consent form will be required for applicants under 18 years old.

PARENT CONSENT

I have given my son/daughter, _______________________________________ the permission to join and be part of

Life Youth Leadership Program of LifeBank Foundation.

I realized the benefits that he/she will derive from this experience which constitutes an essential part of his/her
development as a young leader, LBF shall take necessary precautions to ensure his/her safety during the said
event. I shall not hold LBF and its event facilitators liable for any untoward incident that may arise on account of
his/her own fault or negligence or caused by fortuitous or beyond the control of LBF and its event facilitators.

Parent/ Guardian’s Printed Name over Signature and Date