Vision 2020 Junior Delegate Application
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Name: _____________________________
Age/Date of Birth: __________________________
School: __________________________________________________________________________
Grade: __________________________________________________________________________
Cell Phone Number: __________________
Home Phone Number: _______________________
Address: _________________________________________________________________________
E-mail: __________________________________________________________________________
Are you on Facebook? : _____________________________________________________________
What is the best way to contact you? ___________________________________________________
Use an additional page if necessary for the following questions.
9. Why are you interested in being a member of a Vision 2020 Campus Chapter?
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10. What attributes do you think you will contribute to the Vision 2020 Chapter?
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11. Can you commit to attending meetings and other various events (2 per semester) throughout your
membership with Vision 2020?
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12. Please rank order from 1-5 (with 1 being your first choice and 5 being your last) Vision 2020’s National
Goal areas in which you have the greatest interest:
____ Increasing women in senior leadership positions
____ Pay Equity
____ Family Friendly Workplace Policies
____ Educating New Generations about gender equality
____ Voter Mobilization
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Signature of Applicant
Printed Name of Applicant
Date
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Signature of Parent/Guardian (if 18 or younger)
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Printed Name of Parent/Guardian
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Date