Youth Leadership Birmingham

Youth Leadership Birmingham Application

Prior to completing this application, please review the eligibility requirements and the program calendar to make sure you are able to fully commit.

Applications are due on Monday, September 14, 2026 by 11:59 PM.

Please note: This application will not autosave. We recommend loading the video component first, and then pasting your written responses from a Word or Google Doc after the video successfully loads. Please email katherine@leadershipbirmingham.org with any issues or questions. Thank you!

Yes, I understand the attendance policy and can commit to full participation in YLB if I were to be selected as a member of the YLB Class of 2027. *

*Note: All area superintendents and principals have excused absences for YLB on scheduled program days and you will receive an attendance verification for all days.

Personal Information

First Name*

Middle Name

Last Name*

Preferred Name (printed on nametags)

Have you submitted an application to YLB in the past?*

Yes

Gender*

Race*

Date of Birth*

Current Grade*

10th Grade

11th Grade

School*

Phone*

Email*

Please type this correctly — we'll use this address to communicate with you.

Home Address*

Names of Parent(s)/Guardian(s)*

Parent/Guardian Email*

Parent/Guardian Phone*

Activities & Accomplishments

Extracurricular Activities

Honors & Awards

Essay Questions

Answer the following essay prompts thoughtfully. There is no strict word limit, but aim for clear and concise responses.

Describe a time you demonstrated leadership*

0 words

How have you contributed to your community?*

0 words

What are your goals for this program?*

0 words

Reference

List the name and email of your reference. IMPORTANT: They will automatically receive an email with a link to the online reference form.

Reference Name*

Reference Email*

Video Application

Upload a video (3 minutes maximum) telling us about yourself, your leadership experience, and why you want to join this program.

Video Upload *

Interview Confirmation

I understand that if I am selected as a Finalist, I will need to interview the afternoon/evening of either October 5th or October 6th. I also understand that these are the only two options for interviews. I have cleared my calendar for the following date(s) in order to meet this requirement. *

Please check all dates and times that work for you: *

Monday, October 5th

October 5 · 4:00 PM – 5:30 PM

October 5 · 5:30 PM – 7:00 PM

Tuesday, October 6th

October 6 · 4:00 PM – 5:30 PM

October 6 · 5:30 PM – 7:00 PM

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