The Alex Registration Form - Calgary Youth Justice Society

The Alex Registration Form - Spring 2025

I have talked to the young person I want to nominate and they are interested and ready to join the program for the full semester.(Required)

Yes

Youth Name(Required)

First Last

Pronouns of Young Person(Required)

Example: he/him, she/her, they/them

Email of Young Person(Required)

Phone of Young Person(Required)

Person Nominating(Required)

First Last

Email of Person Nominating(Required)

Phone of Person Nominating(Required)

Is the Person Nominating also the Guardian?(Required)

Yes

Do you give In the Lead staff consent to text, call or email the nominated young person to communicate with them about the program?(Required)

Yes

What strengths do you see in this young person?(Required)

EXAMPLE: I feel that Seth would make a great candidate for the In the Lead program as he is wise beyond his years. He is kind, genuine and compassionate and has shown a tremendous amount of growth since I started working with him. Seth is resilient and tries hard to never give up on his goals and dreams. He is also very reliable and dependable and shows up for appointments regularly and on time.

What strengths and leadership qualities do you see them demonstrating in their communities (school, neighbourhood, within your organization, etc...)?(Required)

EXAMPLE: Seth has huge potential as a leader in his community and for his peers. He has a huge heart and he is continually working towards not only his own personal growth but supports others in their journey towards health and wellbeing by co-facilitating a meditation class for his peers in recovery. He shows initiative by planning for the class but is also adaptable and flexible to meet the needs of the class participants. Seth is always willing to lend a listening ear to anyone who needs support and advice.

Why do you think they would be a good candidate for this strength based leadership development opportunity?(Required)

EXAMPLE: I believe being part of the group would allow Seth to meet new people and develop positive relationships. Having Seth as part of In the Lead would enhance not just his growth but everyone else’s in the group as well as he has so much to offer as a young leader. I am so proud and excited to nominate Seth for In the Lead. You couldn’t ask for a better candidate.

Please ensure you see a confirmation screen and receive a confirmation email after submitting this form. If you do not, we also did not receive the referral. If you have concerns or are unsure please email: awan@cyjs.ca