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Applicant First Name: Last Name: Address: City: Zip: Phone: Email: High school: Year in school: Junior / Senior Teacher/Counselor Reference Name: Phone: Email: Parent/Guardian Name: Phone: Email:
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It is the Young Leaders Program application for Assembly District 13.
Young leaders who reside in Assembly District 13 are required to file the application.
The application can be filled out online or submitted in person to the designated office.
The purpose is to select and develop young leaders from Assembly District 13.
The application requires personal information, leadership experience, and a statement of interest.
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