YAC Application

Along with this application please submit 2 recommendation forms, one from a peer and one from an adult (non-relative).
Recommendations can be emailed or faxed to: Jennifer Grantham at Jennifer@specialolympicsarkansas.org or fax to
(501) 771-1020.

State YAC Application

PERSONAL INFORMATION

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Cell Number *

Secondary Phone Number *

Number of years involved with Special Olympics *

Date of Birth *

Email *

EMERGENCY CONTACT

Emergency Contact *

First

Last

Relationship to applicant *

Phone Number *

Email *

EDUCATION

High School/University Name *

Grade/Year *

Major (If applicable) *

QUESTIONNIARE

1. What Special Olympics sports and events have you participated in? *

3. What does Special Olympics mean to you? *

5. Describe how you have reached out to help others in your community. *

2. Describe specific roles you have played in Special Olympics events. *

4. What leadership roles have you held in other school and/or volunteeer organizations? *

6. Why do you want to be a part of Arkansas Youth Activation Committee? *

7. What other activites (school and community) are you involved in, and what are your plans for balancing Arkansas YAC duties with your other activities? *

Submit