Four Star Leadership

Take the challenge! Accept the opportunity! Learn to lead with General Tommy Franks.

Student Application Form

Thank you for your interest in Four Star Leadership with General Tommy Franks. Invitations for the Four Star program have been sent to schools and civic organizations across America and are open to all. This application form, together with your recommendation form, will serve to differentiate you from the other candidates, helping us to select the final participants. You will be notified at the beginning of May if you have been selected for the program. Applications without an associated recommendation cannot be considered.

Important

By filling out the following form, you understand that:

• Four Star Leadership with General Tommy Franks is an ALL INCLUSIVE PROGRAM (attendee’s travel, room and board, and program necessities are provided)
• You must submit a recent photograph (further instructions are emailed once you apply)
• You must submit your Application, Recommendation, and Photograph by 5:00 p.m., May 15th, 2013!
• 70 Finalists will be chosen and a phone interview will be conducted with each (from May 1-15, 2013) to determine the 50 attendees (announced May 20, 2013).
• Once the 50 attendees and 3 alternates are notified and announced, additional curriculum and details will be delivered to each and travel arrangements will be made

• Student Details

• First Name*
• Last Name*
• School*
• Address*
• Address 2
• City*
• State/Province/Region*
• Zip/Postal Code*
• Country*
  AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayNorthern Mariana IslandsOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbia and MontenegroSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe
• Email*
• Phone (###)###-####*
• Grade Next Fall*
  9th10th11th (preferred)12th
• Current GPA*
• Gender*
  MaleFemale
• T-Shirt Size*
  SMLXL

• Parent/Guardian Details

• First Name*
• Last Name*
• Phone(###)###-####*
• Email
• Address
• Address 2
• City
• State/Province/Region
• Zip/Postal Code
• Country
  AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayNorthern Mariana IslandsOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbia and MontenegroSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe
• Emergency Contact Name*
• Emergency Contact Phone Number*

• Experience

• List organizations you are a member of and your leadership role in them.*
• Leadership Experience and Impact*
• Share an example of how you lead through service.*

• Reference

  Please provide information for a school official, such as a counselor, we can contact concerning your application.
• First Name*
• Last Name*
• Title*
• Relationship to Student*
• Email*
• Phone*

• Agreement Information

  I hereby agree that all information on this form and attached forms is true and correct to the best of my knowledge and give permission for my child to attend Four Star Debate, July 15-21, 2012. I understand that all costs (including roundtrip airfaire, room, and board) are covered by scholarships and sponsors, with the exception of spending money and possible baggage charges which vary by airline. I also understand that if my student should be dismissed from the program or chooses to leave early for any reason, I am responsible for his/her immediate transport home from Will Rogers World Airport, Oklahoma City, Oklahoma.

  
  

  AUTHORIZATION FOR MEDICAL EMERGENCY TREATMENT:
  If your child sustains a non life-threatening injury, the law requires that a hospital have parental consent before beginning treatment. This form allows you to give the necessary permission, even if your child is under the care of another adult.

  
  

  I (we) the undersigned parent(s) or legal guardian(s) of the minor listed authorize the staff of Four Star Leadership to provide consent for emergency medical care for my child named above if unable to reach me.

  
  

  AUTHORIZATION TO UTILIZE PHYSICAL LIKENESS, NON-UNION PRODUCTION:
  I expressly grant to Four Star Leadership, the General Tommy Franks Leadership Institute and Museum, the National Center for Policy Analysis, Oklahoma Christian University, Oklahoma Council of Public Affairs, and to their employees, agents and assigns, the right to photograph and videotape me and use my picture, silhouette and other reproductions of my physical likeness (as the same may appear in any still camera photograph and/or videotape) in and in connection with the exhibition on television, the internet, cassette, DVD or otherwise, of all the television shows, conventions, “clips” promos, magazine, newspaper articles, etc. in which my participation is included and in which the same may be used or incorporated and utilized throughout the world, and also in the advertising, utilizing and/or publicizing of any such image, but not limited to television. These groups shall have the ability to edit the program/video as it so requires. I further give these groups the right to reproduce in any manner whatsoever any recordation made by said company of my voice and all instrumental, musical, or other sound effects produced by me.

• Electronic Signature

  By entering your names and submitting this application, you agree to the above terms.
• Students' Name*
• Parent/Guardian's Name*
  If you are accepted to the trip, you will receive a travel folder with a physical copy of this form to be signed and returned.

Please submit your information online. If you have any other correspondence, send to:

General Tommy Franks Leadership Institute & Museum
PO Box 222
Hobart, OK 73651
F: 580-726-5901
warren@tommyfranksmuseum.org